阿托伐他汀在PCI围术期强化治疗冠脉分叉病变的可行性、安全性及远期预后分析

Feasibility,Security and Long-term Prognosis Analysis of Atorvastatin for the Patient with Bifurcation Coronary Artery Lesion during the Percutaneous Coronary Intervention Treatment

目的:研究经皮冠状动脉介入(PCI)围术期阿托伐他汀强化治疗冠脉分叉病变的可行性、安全性及远期预后效果。方法:选取2017年8月-2018年7月拟于本院行PCI的患者56例作为研究对象,给予为期10周的阿托伐他汀治疗。观察患者治疗前和治疗2、5、10周的低密度脂蛋白(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)、总胆固醇(TC)、血浆脂蛋白磷脂酶A2(Lp-PLA2)、糖化血红蛋白(HbA1c)、C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子(TNF-α)水平,统计患者并发症发生情况及随访期间的情况。结果:与治疗前相比,患者治疗2、5、10周的LDL-C、TG、TC、Lp-PLA2、TNF-α、CRP、HbA1c和IL-6均明显降低,HDL-C则明显升高,差异均有统计意义(P<0.05)。患者服药期间出现皮疹1例(1.79%)。随访期间出现心血管不良事件2例(3.57%),患者生存率为100%。结论:冠脉分叉病变患者PCI围术期使用阿托伐他汀可有效降低患者的LDL-C、TG、TC、Lp-PLA2、TNF-α、CRP、HbA1c和IL-6,改善患者HDL-C水平,减少围术期并发症的发生,改善患者远期预后,具有较高的安全性和可行性,值得临床推广使用。

Objective:To analyze the feasibility,security and long-term prognosis of Atorvastatin use for bifurcation coronary artery lesion during the percutaneous coronary intervention(PCI)treatment period.Method:56 patients with bifurcation coronary artery lesion in our hospital from August 2017 to July 2018 in PCI treatment were selected as research object.All the patients were treated with Atorvastatin for 10 weeks time.The level of low density lipoprotein(LDL-C),high density lipoprotein cholesterol(HDL-C),total triglyceride(TG),total cholesterol(TC),plasma lipoprotein phospholipase A2(Lp-PLA2),glycosylated hemoglobin(HbA1 c),c-reactive protein(CRP),interleukin 6(IL-6),tumor necrosis factor(TNF-α)before treatment and at 2,5,10 weeks treatment of the patents were observed.The complications and the prognosis effect for the patients after six months follow-up were statistics.Result:Compared with before treatment,the level of LDL-C,TG,TC,LpPLA2,TNF-α,CRP,HbA1 c and IL-6 at 2,5,10 weeks treatment were significantly reduced,and the level of HDL-C was significantly increased,the differences were statistically significant(P<0.05).The rash appeared in 1 case(1.79%).Cardiovascular adverse events occurred in 2 cases(3.57%)during six months follow-up.The survival rate of patients was 100%.Conclusion:Atorvastatin can effectively reduce the LDL-C,TG,TC,Lp-PLA2,TNF-α,CRP,HbA1 c and IL-6 level in patients with bifurcation coronary artery lesion during PCI treatment,improve their level of HDL-C,reduce the complications occur,improve the long-term prognosis of patients,it has high security and feasibility and is worthy to popularize and apply in clinical use.