摘要
目的:分析不同他汀类药物对高龄冠心病经皮冠脉介入治疗(PCI)患者心肾功能及心血管事件发生的影响。方法:选取2015年1月-2016年8月本院的已择期进行PCI手术的90例高龄(>60岁)冠心病患者作为研究对象,随机均分为A组(阿托伐他汀组)、B组(瑞舒伐他汀组)、C组(氟伐他汀组),各30例,三组均在常规治疗的基础上加用对应他汀类药物治疗,比较治疗前、治疗6个月三组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)血脂指标,测定患者血肌酐(Scr)、尿酸(UA)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)等肝、肾功能指标的变化,测定患者心肌酶谱,记录肌酸激酶同工酶(CK-MB)及心肌损伤标志物肌钙蛋白(c Tn I)水平的变化,统计各组用药不良反应发生率,三组均随访1年,统计终点事件及主要心血管不良事件(MACE)发生率。结果:治疗6个月后,三组TC、TG、LDL-C均降低,HDL-C均上升,与本组治疗前对比,差异均有统计学意义(P<0.05),三组组间对比,差异无统计学意义(P>0.05)。三组治疗期间肝肾功能异常发生率对比,差异无统计学意义(P>0.05)。治疗前后,三组CK-MB、c Tn I均无明显变化,差异均无统计学意义(P>0.05)。三组治疗期间均未见严重不良反应。三组随访1年MACE发生率对比,差异均无统计学意义(P>0.05)。结论:冠心病患者PCI术前后规律服用他汀类药物,可保护患者心肾功能,可降低MACE发生率,提高治疗的安全性。
Objective:To analyze the effects of different statins on cardiac and renal function and incidence of cardiovascular events in elderly patients with coronary heart disease treated by percutaneous coronary intervention(PCI).Method:Ninety elderly patients( 60 years old) with coronary heart disease who underwent elective PCI in our hospital from January 2015 to August 2016 were randomized into group A(Atorvastatin group),group B(Rosuvastatin group) and group C(Fluvastatin group),30 cases in each group.All groups were treated with statins,based on routine treatment.Before the treatment and 6 months after treatment,the total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C) and other lipid parameters were compared between groups.The changes of serum creatinine(Scr),uric acid(UA),aspartate aminotransferase(AST),alanine aminotransferase(ALT) and other liver and renal function indexes were determined.Myocardial enzymes were also determined.The changes of serum creatine kinase isoenzyme(CK-MB) and cardiac troponin(c Tn I) levels were recorded.The incidence rates of adverse drug reactions in all groups were statistically analyzed.The three groups were followed up for 1 year,and the incidence of major adverse cardiovascular events(MACE) was statistically analyzed.Result:After 6 months of treatment,TC,TG and LDL-C in all groups decreased while HDL-C all increased(P〈0.05),there were no significant differences between the three groups(P〈0.05).There were no significant differences in the incidence of abnormal liver and renal function between the three groups(P〈0.05).Before and after treatment,there were no significant changes in CK-MB and c Tn I between three groups(P〈0.05).During the treatment,there were no serious adverse reactions in the three groups.There were no significant differences in the incidence of MACE between the three groups during 1 year of follow-up(P〈0.05).Conclusion:Regular use of statins in patients with coronary heart disease before and after PCI can protect the cardiac and renal function of patients,reduce the incidence of MACE,and improve the safety of treatment.
作者
劳荣海
LAO Ronghai(Leizhou People’s Hospital,Leizhou 524200,Chin)
出处
《中国医学创新》
CAS
2018年第20期62-65,共4页
Medical Innovation of China
关键词
冠心病
高龄
他汀类药物
PCI
心肾功能
Coronary heart disease
Advanced age
Statins
PCI
Heart and kidney function