术前强化他汀治疗对冠心病患者冠脉介入治疗预后的影响

Effect of preoperative intensive statin therapy on prognosis of patients with coronary heart disease after percutaneous coronary intervention

目的探讨术前强化他汀治疗对冠心病患者冠脉介入治疗预后的影响。方法选取2016年4月至2018年4月在本院接受治疗的40例冠心病患者,均采用冠脉介入治疗,按照入院顺序分成观察组与对照组,对照组术前术后均常规应用20 mg阿托伐他汀,观察组术前应用40 mg阿托伐他汀治疗,术后应用20 mg阿托伐他汀,观察两组患者手术前后肌酸激酶同工酶(CK-MB)、肌钙蛋白-I(TNI)、C反应蛋白(CRP)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、三酰甘油(TG)水平及不良心血管事件。结果对照组术后24 h的CK-MB、TNI、CRP水平均明显提高,与观察组术后24 h对比差异有统计学意义(P<0.05);两组患者术后1个月LDL-C、HDL-C、TC、TG均有明显改善,与术前对比差异有统计学意义(P<0.05),但两组组间差异无统计学意义;术后1年随访,观察组不良心血管事件发生率5.00%显著低于对照组15.00%,差异有统计学意义(P<0.05)。结论术前强化他汀治疗对冠心病患者冠脉介入治疗具有显著效果,可促进机体的稳定性,预防不良心血管事件,值得临床推广使用。

Objective To investigate the effect of preoperative intensive statin therapy on the prognosis of patients with coronary heart disease after percutaneous coronary intervention. Methods 40 patients with coronary heart disease who were treated in our hospital in April 2016 to April2018 were treated with coronary intervention. The patients were divided into the observation group and the control group according to the order of admission. The control group was routinely used 20 mg atorvastatin before and after the operation. The observation group was treated with 40 mg atorvastatin before operation, and 20 mg atorvastatin was applied after the operation. In the two groups, the creatine kinase isoenzyme(CK-MB), troponin-I(TNI), C reactive protein(CRP), low density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C), total cholesterol(TC), three acyl glycerol(TG), and adverse cardiovascular events were observed before and after the operation. Results The level of CK-MB, TNI and CRP of 24 h in the control group increased significantly after operation, and the difference of 24 h in the observation group was statistically significant(P<0.05). The two groups were significantly improved in 1 months after the operation, LDL-C, HDL-C, TC and TG were significantly improved(P<0.05), but there was no significant statistical difference between the two groups. After 1 years of follow-up, the incidence of adverse cardiovascular events in the observation group was 5% significantly lower than that of the control group(15%), and the difference was statistically significant(P<0.05). Conclusion Preoperative statin therapy has significant effect on coronary intervention in patients with coronary heart disease.It can promote the stability of the body and prevent adverse cardiovascular events. It is worthy of clinical application.