强化他汀治疗对择期PCI术后无复流和血脂的疗效

Therapeutic effect of intensive statin therapy on no-reflow and blood lipid after selective percutaneous coronary intervention

目的:观察强化他汀治疗对择期经皮冠脉介入治疗(PCI)术后冠脉无复流发生率及血脂、高敏C反应蛋白(hsCRP)的疗效。方法:选择100例择期PCI患者,随机均分为强化他汀组和常规治疗组。强化他汀组于术前2日给予阿托伐他汀80mg/d口服预处理,术后改为40mg/d,服用1个月,后改为20mg/d长期服用。常规治疗组术前2日给予阿托伐他汀20mg/d预处理,术后20mg/d长期服用。观察比较两组术前、术后1月校正的TIMI帧数(CTFC),术后无复流的发生率、术后1个月血浆高密度脂蛋白-胆固醇(HDL-C)、低密度脂蛋白-胆固醇(LDL-C)及hsCRP水平。结果:两组患者无复流发生率无显著差异(P>0.05);但PCI术后1月与常规治疗组比较,强化他汀组平均CTFC[(37±6)帧比(29±6)帧,P<0.01];血浆hsCRP[(26.65±3.56)mg/L比(24.9±3.42)mg/L]和LDL-C[(3.36±0.82)mmol/L比(2.46±0.32)mmol/L]水平显著降低(P<0.05或<0.01)。结论:强化他汀治疗可以降低术后即刻校正的TIMI帧数,还可以明显降低LDL-C和hsCRP水平。

Objective： To observe therapeutic effect of intensive statin therapy on incidence rate of coronary no - reflow, levels of blood lipids and high sensitivity C reactive protein （hsCRP） in coronary intervention （PCI）. Methods： A total of 100 patients undergoing selective PCI were randomly and equally divided into intensive statin group （received 80 mg/d atorvastatin preconditioning 2d before PCI, 40 mg/d after PCI for one month, then 20 mg/d for long term） and routine treatment group （received 20 mg/d atorvastatin precondtioning 2d before PCI, then 20 mg/d after PCI for long term） . Corrected TIMI frame count （CTFC） before and 1 month after PCI , incidence rate of no - reflow after PCI , plasma levels of high density lipoprotein cholesterol （HDL-C） , low density lipoprotein cholestero l （LDL-C） and hsCRP on one month after PCI were observed and com-pared between two groups. Results： There was no significant difference in incidence rate of no - reflow between two groups （ P〉 0. 05）. Compared with routine treatment group one month after PCI, there was significant reduction in meanCTFC [（37 土 6） frames vs. （29 土 6） frames] . in plasma leves of hsCRP [ （ 2 6 . 65 土 3. 56） m g /L v s （24.9 土 3. 42） mg/L] and LDL-C [ （3. 36 土 0. 82） mmol/L v s （2. 46 土 0. 32） mmol/L] in inten s ie statin group one month after PCI , P〈0. 05 or 〈0. 01. Conclusion： Intensive statin therapy can reduce not only but also plasma levels of LDL-C and hsCRP.