不同剂量阿托伐他汀对非ST段抬高型心肌梗死患者PCI术后影响

Effects of Different Dose of Atorvastatin on PCI in Patients with Non-ST Elevation Myocardial Infarction

目的探讨不同剂量阿托伐他汀对非ST段抬高型心肌梗死患者经皮冠脉介入治疗(PCI)术后的影响。方法选取2014年1月—2016年5月在该院进行PCI治疗的非ST段抬高型心肌梗死患者60例,随机分为两组,各30例。对照组实施常规剂量阿托伐他汀治疗,观察组采用强化阿托伐他汀治疗,对比两组临床指标[超敏C反应蛋白(hsCRP)、肌酸激酶同工酶(CK-MB)、肌钙蛋白T(cTnT)、同型半胱氨酸(HCY)、低密度脂蛋白胆固醇(LDL-C)]及心血管不良事件发生率。结果术后24h,观察组hs-CRP、CK-MB、cTnT、HCY、LDL-C水平分别为[(11.2±4.2)mg/L、(156.4±78.7)U/L、(15.3±4.9)ng/mL、(10.1±2.6)μmol/L、(1.3±0.8)mmol/L]较对照组[(16.2±9.7)mg/L、(213.1±123.2)U/L、(21.6±6.6)ng/mL、(13.2±1.9)μmol/L、(1.9±0.8)mmol/L]明显改善,差异有统计学意义(P<0.05);观察组主要不良心脏事件(MACE)、心源性死亡、非致死性心肌梗死、靶血管再次重建、严重心力衰竭及全因死亡发生率(分别为13.3%、3.3%、3.3%、3.3%、6.7%、3.3%)与对照组(16.7%、6.7%、3.3%、3.3%、6.7%、6.7%)比较差异无统计学意义(P>0.05)。结论强化阿托伐他汀可降低非ST段抬高型心肌梗死患者PCI术后hs-CRP、CK-MB、cTnT、HCY、LDL-C水平,改善患者心肌损伤情况,且未增加术后心血管不良事件发生率。

Objective To investigate the effects of different dose of atorvastatin on percutaneous coronary intervention （PCI） in patients with non-ST elevation myocardial？infarction （NSTE-MI）. Methods 60 NSTE-MI patients received PCI in our hospital from January 2014 to May 2016 were randomly divided into two groups, 30 cases in each. Control group took con- ventional dose of atorvastatin, observation group took high-dose atorvastatin. The clinical indexes [hs-CRP, CK-MB, cTnT, HCY, LDL-C] and incidence of adverse cardiac events of two groups were compared. Results 24 h after surgery, the hs- CRP, CK-MB, cTnT, HCY, LDL-C levels of observation group [（11.2±4.2）mg/L,（156.4±78.7）U/L, （15.3±4.9）ng/mL, （10.1± 2.6）μmol/L, （1.3±0.8）mmol/L] significantly improved compared with control group[（16.2±9.7）mg/L, （213.1±123.2）U/L, （21.6±6.6）ng/mL, （13.2±1.9）μmol/L, （1.9±0.8）mmol/L]（P〈0.05）; The ineidenee of major adverse cardiac events （MACE）, cardiac death, nonfatal myoeardial infarction, target vessel revaseular- ization, serious heart failure and all-eause mortality in obser- vation group （13.3%, 3.3%, 3.3%, 3.3%, 6.7%, 3.3%） wascompared with control group （16.7%, 6.7%, 3.3%, 3.3%, 6.7%, 6.7%）, there was no significant difference （P〉0.05）. Con- clusion High-dose atorvastatin can decrease postoperative hs-CRP, CK-MB, cTnT, HCY, LDL-C levels of NSTE-MI pa- tients, improve conditions of myocardial damage, and not increase the incidence of postoperative adverse cardiac events.