不同目标水平低密度脂蛋白胆固醇对PCI术终点复合事件的影响研究

Influence of low density lipoprotein cholesterol with different target levels on term inal complex events in PCI

目的探讨不同目标水平低密度脂蛋白胆固醇(LDL-C)对经皮冠状动脉介入术(PCI)患者终点复合事件的影响。方法将解放军第91医院行PCI的冠心病患者291例按照LDL-C不同目标水平分为<70 mg/d L组、70~100 mg/d L组和>100 mg/d L组,随访各组患者调脂药物应用及终点复合事件情况。结果 70~100 mg/d L组阿托伐他汀应用剂量及联合非他汀类调脂药使用率明显低于<70 mg/d L组,骨骼肌肉系统不良反应明显低于<70 mg/d L组,两组分别比较差异具有统计学意义(P<0.05)。70~100 mg/d L组阿托伐他汀应用剂量明显高于>100 mg/d L组(P<0.05),但联合非他汀类调脂药使用率及骨骼肌肉系统不良反应与>100 mg/d L组比较差异无统计学意义(P>0.05)。70~100 mg/d L组复合终点事件明显低于>100 mg/d L组,两组分别比较差异具有统计学意义(P<0.05)。70~100 mg/d L组与<70 mg/d L组复合终点事件比较差异无统计学意义(P>0.05)。结论LDL-C目标水平70~100 mg/d L可能会使接受PCI的冠心病患者同样受益,但需强调个体化治疗,且需更多证据支持。

Objective To investigate the influence of low density lipoprotein cholesterol（LDL-C） with different target levels on terminal complex events in percutaneous coronary intervention（PCI）.Methods 291 cases with coronary heart disease undergoing PCI at No.91 PLA Hospital were divided into 〈 70 mg/dL group,70- 100 mg/dL group and 〉 100 mg/dL group according to different LDL-C target levels.The application of ester regulating drugs and terminal complex events in each group were followed-up.Results The usage rate of Atorvastatin dose and combined non-statin ester regulating drugs in 70 ～ 100 mg/dL group was significantly lower than that in 〈 70 mg/dL group, and the musculoskeletal adverse reaction rate was significantly lower than that in 〈 70 mg/dL group, with differences of sta- tistical significance respectively（P〈0.05）.The usage rate of Atorvastatin dose in 70～100 mg/dL group was signifi- cantly higher than that in 〉 100 mg/dL group（P〈0.05）, while the usage rate of combined non-statin ester regulating drugs and the museuloskeletal adverse reaction rate showed no difference of statistical significance compared with 〉 100 mg/dL group （P〉0.05）.The terminal complex events of 70～ 100 mg/dL group were significantly fewer than those of 〉 100 mg/dL group, with differences of statistical significance respeetively（P〈0.05）.But the terminal com- plex events between 70～ 100 mg/dL group and 〈 70 mg/dL group showed no difference of statistical significance（P〉 0.05）.Conclusion The LDL-C target level of 70-100 mg/dL may benefit the sufferers with coronary heart disease undergoing PCI, but there should be individualized treatment and more evidence to support.