PCI术前负荷剂量瑞舒伐他汀对心功能及cTnI、CysC水平的影响

Effects of preoperative loading dose of rosuvastatin on cardiac function and cTnI and CysC levels in patients before PCI

目的探讨经皮冠状动脉介入术(PCI)前服用负荷剂量瑞舒伐他汀对急性冠脉综合征(ACS)患者早期心功能及心肌肌钙蛋白I(cTnI)、胱抑素C(CysC)水平的影响。方法选取在医院治疗的192例ACS患者,随机分为观察组和对照组各96例。观察组在行PCI术前2 h口服瑞舒伐他汀40 mg负荷剂量,PCI术后服用5 mg,1次/晚;对照组仅在PCI术后口服瑞舒伐他汀5 mg,1次/晚。比较两组PCI术前和术后2 d的心功能,血清cTnI、CysC水平,住院期间主要心血管不良事件(MACE)发生率。结果 PCI术前两组LVEDD及LVEF比较,无统计学差异(P>0.05);PCI术后两组LVEF均显著升高,而LVEDD均显著降低(P<0.05),且观察组的LVEF和LVEDD变化幅度均显著大于对照组(P<0.05)。PCI术前两组cTnI值比较,无统计学差异(P>0.05);PCI术后两组cTnI和CysC值均显著升高(P<0.05),但观察组升高幅度低于对照组(P<0.05)。PCI术后观察组CysC值无显著变化(P>0.05),而对照组CysC值显著高于PCI术前(P<0.05)。观察组住院期间MACE发生率(8.33%)显著低于对照组(22.92%)(P<0.05)。结论 PCI术前给予负荷剂量瑞舒伐他汀可有效改善ACS患者PCI术后心功能,保护心肌细胞,减少住院期间的MACE,值得临床推广使用。

Objective To explore the effects of preoperative loading dose of rosuvastatin administered before percutaneous coronary intervention（PCI） operation on early cardiac function and cardiac troponin I（cTnI） and Cystatin C（CysC） levels in patients with acute coronary syndrome（ACS）. Methods A total of 192 patients with ACS treated in our hospital were selected and randomly divided into an observation group and a control group（n =96, respectively）. 2 h before PCI operation, the observation group was administered with 40 mg loading dose of rosuvastatin, and after PCI operation 5 mg, once per night; the control group was only administered with 5 mg of rosuvastatin after the operation, once per night. The cardiac function and cTnI and CysC levels in patients before PCI and 2 d after the operation, and the incidence of major adverse of cardiovascular events（MACE） during hospitalization between the two groups were compared. Results Before the operation, there was no significant difference in LVEDD and LVEF between the two groups（P〈 0.05）; after the operation, LVEF in both groups increased significantly while LVEDD decreased significantly（P 〈0.05）, and the variation range of LVEF and LVEDD in the observation group was significantly higher than that in the control group（P 〈0.05）. There was no statistical difference in the preoperative cTnI values between the two groups（P〈 0.05）, but the postoperative cTnI and CysC values between the two groups increased significantly（P 〈0.05） and the increased range in the observation group was lower than that in the control group（P 0.05）. There was no significant change in the postoperative CysC value in the observation group（P 〈0.05）, while the postoperative CysC value in the control group was significantly higher than the preoperative one（P 〈0.05）. The incidence of MACE in the observation group（8.33%） was significantly lower than that in the control group（22.92%）（P 〈0.05）. Conclusion The loading dose of rosuvastatin before PCI operation can effectively improve the postoperative cardiac function of patients with ACS, protect the myocardial cells, reduce MACE during hospitalization, and is worthy of clinical use.