冠状动脉旁路移植术后短期内应用强化他汀对患者出血风险的研究

Bleeding risk of short-term intensive statin therapy after coronary artery bypass grafting

目的观察冠状动脉旁路移植术后短期内应用强化他汀治疗对患者出血风险的影响。方法接受冠状动脉旁路移植术治疗的患者240例，将240例患者随机分成试验组和对照组，各120例。两组患者均规范化给予药物常规治疗，在围手术期均予以低分子量肝素抗凝治疗。试验组在术前给予40mg／d阿托伐他汀，顿服，术后40mg／d，口服1个月；对照组在手术前后一直以10mg阿托伐他汀口服治疗，服药1个月后，比较两组患者血小板聚集率及出血情况。结果术后试验组患者血小板最大聚集率为（14．5±3．7）％，血小板聚集抑制率为（79．5±4．3）％，术后出血发生率为27．5％。对照组分别为（38．1±7．4）％、（50．8±10．2）％和12．5％，两组比较差异均有统计学意义（P〈0．05）。结论冠状动脉旁路移植术后短期内应用强化他汀治疗可导致出血风险增加。

Objective To observe the bleeding risk of short-term intensive statin therapy after coronary artery bypass grafting. Methods A total of 240 patients treated with coronary artery bypass grafting were randomly divided into group A （ experimental group） and group B （ control group ）. All pa- tients were normalized to conventional treatment and they were given low molecular weight heparin for an- ticoagulant therapy during the perioperative period. Patients in group A were given 40 mg of atorvastatin before surgery, and 40 mg of atorvastatin every night for one month after the surgery. Patients in group B were given 10 mg of atorvastafin every night during the treatment. One month after the operation, platelet aggregation rate and bleeding events of patients were compared. Results There were significant differ- enees in maximum platelet aggregation rate [ （ 14.5 ± 3.7 ） % vs （ 38.1 ± 7.4 ） %, P 〈 0. 05 ], inhibition rate of platelet aggregation [ （ 79.5 ± 4.3 ） % vs （ 50.8 ± 10.2 ） %, P 〈 0.05 ], and incidence of postopera- tive bleeding[27.5% vs 12.5%,P〈0. 05]between group A and B,respectively. Conclusion Short- term intensive statin therapy can increase the bleeding risk after coronary artery bypass grafting.