PCI术前他汀再负荷方式对冠心病患者的疗效

Therapeutic effect of statin reloading before PCI in patients with coronary heart disease

目的:探讨PCI术前他汀负荷方式对冠心病患者的疗效。方法:选择我院120例冠心病患者为研究对象,随机均分为:常规剂量组(入院至术前每日阿托伐他汀20mg)、40mg组(连续7d给40mg阿托伐他汀)、80mg组(术前7d每日给80mg阿托伐他汀)。比较三组的疗效。结果:三组患者治疗后白细胞介素(IL)-8、hsCRP水平均较治疗前显著降低,治疗后1d,与常规剂量组和40 mg组比较,80 mg组IL-8[(50.22±15.32)pg/ml、(32.52±13.21)pg/ml比(28.64±9.53)pg/ml]、hsCRP[(10.38±5.46)mg/L、(8.26±2.07)mg/L比(6.83±1.75)mg/L]水平均显著降低(P均<0.05)。三组患者治疗28d后心脏LVEF均较治疗前显著上升(P<0.05),且与常规剂量组和40mg组比较,80mg组LVEF[(49.2±5.3)%比(53.4±5.2)%比(56.6±4.9)%]明显升高(P<0.05)。与常规剂量组和40mg组比较,80mg组PCI术后1年内不良心血管事件(40.0%比17.5%比5%)及支架内再狭窄率(7.5%比5.0%比2.5%)明显降低(P均<0.05)。结论:PCI术前他汀负荷治疗冠心病疗效显著,能够显著降低,IL-8与hsCRP水平,支架内再狭窄率及心血管事件率,以80mg再负荷效果最优。

Objective：To explore therapeutic effect of statin re-loading before percutaneous coronary intervention（PCI）in patients with coronary heart disease（CHD）.Methods：A total of 120 CHD patients were selected from our hospital.They were randomly and equally divided into routine dase group（20mg atorvastatin from admission to before PCI）,40 mg group（received 40 mg atorvastatin 7dbefore PCI）and 80 mg group（received 80 mg atorvastatin before PCI）.Results：Compared with before treatment,there were significant reductions in levels of IL-8and hsCRP in three groups after treatment;compared with routine dose group and 40 mg group on 1dafter treatment,there were significant reductions in levels of IL-8[（50.22±15.32）pg/ml,（32.52±13.21）pg/ml vs.（28.64±9.53）pg/ml]and hsCRP[（10.38±5.46）mg/L,（8.26±2.07）mg/L vs.（6.83±1.75）mg/L]in 80 mg group,P〈0.05 all.Compared with before treatment,there were significant improvements in LVEF on 28 dafter treatment in three groups（P〈0.05）,compared with no routine dose group and40 mg group,there was significant rise in LVEF[（49.2±5.3）% vs.（53.4±5.2）% vs.（56.6±4.9）%]in 80 mg group（P〈0.05）.Compared with routine dose group and 40 mg group,there were significant reductions in incidence rate of cardiovascular events（40.0% vs.17.5% vs.5%）and in-stent restenosis rate（7.5% vs.5.0% vs.2.5%）within one year after PCI in 80 mg group,P〈0.05.Conclusion：Statin re-loading therapy before PCI possesses good therapeutic effects on CHD,which can significantly reduce levels of IL-8and hsCRP,in-stent restenosis rat,cardiovascular events and 80 mg reloading has the best therapeutic effect.