PCI术前阿托伐他汀强化给药对非ST段抬高性心肌梗死患者术后相关指标的影响

Effects of Intensive Atorvastatin Therapy on Postoperative Related Indexes in Non-ST Segment Elevation Myocardial Infarction Patients before PCI

目的:探讨经皮冠状动脉介入术(PCI)术前阿托伐他汀强化给药对非ST段抬高性心肌梗死(NSTEMI)患者术后血脂、炎症反应及主要不良心脏事件(MACE)发生的影响。方法:120例择期行PCI术的NSTEMI患者随机分为对照组(60例)和观察组(60例)。两组患者入院后立即口服阿司匹林肠溶片0.3 g,每日1次+硫酸氢氯吡格雷片300 mg,每日1次,术后继续用药,共用12周。在此基础上,对照组患者术后立即给予阿托伐他汀钙片口服首次80 mg,后40 mg,每日1次,连用12周;观察组患者在对照组治疗的基础上于术前6 h口服阿托伐他汀钙片40 mg。观察两组患者手术前后三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素10(IL-10)水平和术后MACE发生率、术后再住院率及不良反应发生情况。结果:两组患者手术前后TG、TC、HDL-C、LDL-C水平比较,差异均无统计学意义(P>0.05)。术后,两组患者hs-CRP、TNF-α、IL-10水平均显著高于同组术前,但观察组显著低于对照组,差异均有统计学意义(P<0.05)。两组患者术后MACE发生率、术后再住院率、不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:PCI术前阿托伐他汀强化给药可有效降低NSTEMI患者术后的炎症反应水平,但对血脂水平和MACE发生风险无显著改善,且未增加不良反应的发生。

OBJECTIVE：To investigate the effects of intensive atorvastatin therapy on postoperative blood lipid,inflammation reaction and major adverse cardiac events（MACE）in non-ST segment elevation myocardial infarction（NSTEMI）patients before PCI. METHODS：A total of 120 NSTEMI patients underwent selective PCI were randomly divided into control group（60 cases）and observation group（60 cases）. Both groups were given Aspirin enteric-coated tablet 0.3 g orally,once a day＋Clopidogrel sulfate tablet 300 mg orally,once a day,immediately after admission. After operation,they were given medicine continuously for consecutive 12 weeks. Control group was given Atorvastatin calcium tablet 80 mg orally,immediately after operation,and then was given 40 mg,once a day,for consecutive 12 weeks. Observation group was additionally given Atorvastatin calcium tablet 40 mg orally 6 h before operation on the basis of control group. The levels of TG,TC,HDL-C,LDL-C,hs-CRP,TNF-α and IL-10 before and after PCI,the incidence of postoperative MACE,postoperative re-hospitalization rate and the occurrence of ADR were observed in 2 groups. RESULTS：There was no statistical significance in the levels of TG,TC,HDL-C or LDL-C between 2 groups before and after operation（P〈0.05）. After operation,the levels of hs-CRP,TNF-α and IL-10 in 2 groups were significantly higher than before operation,and the observation group was significantly lower than the control group,with statistical significance（P〈0.05）. There was no statistical significance in the incidence of postoperative MACE,postoperative re-hospitalization rate or the incidence of ADR between 2 groups（P〉0.05）. CONCLUSIONS：Intensive atorvastatin therapy before PCI can effectively reduce the levels of inflammatory response in NSTEMI patients,but have no significant changes in blood lipid levels and MACE risk,without increasing the incidence of ADR.