PCI后转氨酶升高患者他汀减半联合脂必泰观察

Statin halve combined with lipidide in patients with elevated transaminase after PCI

目的:观察原剂量他汀减半联合脂必泰对经皮冠状动脉介入治疗(Percutaneous Coronary Intervention,PCI)术后转氨酶升高患者肝脏功能、血脂水平及临床心血管不良事件的发生情况。方法:选取PCI术后使用他汀降脂治疗且转氨酶升高患者40例,所有患者均给予原剂量他汀减半联合脂必泰0.24 mg,早晚各1片治疗,在治疗后1个月、3个月进行两次随访收集肝脏功能、血脂指标并记录临床心血管不良事件发生情况,比较干预前后肝脏功能、血脂水平及不良反应。结果:干预前谷丙转氨酶(Alanine Amiotransferase,ALT)(82.05±31.74)U/L,谷草转氨酶(Aspartate Transaminase,AST)(60.35±33.12)U/L与干预后1个月ALT(46.58±20.61)U/L,AST(37.32±34.28)U/L干预后3个月ALT(31.88±6.48)U/L,AST(26.93±5.75)U/L相比指标下降差异有统计学意义(P <0.001);干预前患者总胆固醇(Serum Total Cholesterol,TC)(3.49±0.79)mmol/L,三酰甘油(Triglyceride,TG)(1.57±0.66)mmol/L,低密度脂蛋白胆固醇(Low Density Lipoprotein Chesterol,LDL-c)(1.84±0.61)mmol/L,高密度脂蛋白胆固醇(High Density Lipoprotein Chesterol,HDL-c)(1.01±0.22)mmol/L,载脂蛋白A(Apolipoprotein A,ApoA)(1.21±0.19)mmol/L,载脂蛋白B(Apolipoprotein B,ApoB)(0.78±0.20)mmol/L与干预后1个月TC(3.51±0.88)mmol/L,TG(1.47±0.54)mmol/L,LDL-c(2.06±0.86)mmol/L,HDL-c(1.08±0.31)mmol/L,ApoA(1.24±0.24)mmol/L,ApoB(0.79±0.20)mmol/L干预后3个月TC(3.37±0.10)mmol/L,TG(1.58±0.61)mmol/L,LDL-c(1.88±0.88)mmol/L,HDL-c(1.02±0.25)mmol/L,ApoA(1.17±0.21)mmol/L,ApoB(0.80±0.31)mmol/L与干预前相比各血脂水平指标差异无统计学意义(P> 0.05);干预后尿素氮(Blood Urea Nitrogen,BUN)(5.55±3.25)mmol/L,肌酐(Creatinine,Cre)(72.04±13.17)μmol/L,尿酸(Uric Acid,UA)(352.86±74.81)μmol/L与干预前相比差异无统计学意义(P> 0.05),在观测期间所有患者均无不良反应及临床心血管不良事件发生。结论:PCI术后使用他汀降脂治疗出现转氨酶升高患者治疗中,采用原剂量他汀减半联合脂必泰治疗可有效改善肝脏功能,持续降低血脂水平,安全有效,具有使用价值。

Objective:To observe the incidence of liver function,blood lipid levels and clinical cardiovascular adverse events in patients with elevated transaminase after PCI treated with original statin halved combined with lipidide.Methods:Forty patients with statin lipid-lowering therapy and elevated transaminase were enrolled in the study.All patients were given the same dose of statin halved with lipidide 0.24 mg,one capsule each morning and evening,after treatment in the first month and three months,the liver function,blood lipids and the occurrence of clinical cardiovascular adverse events were recorded.Liver function,blood lipid levels and adverse reactions were compared before and after intervention.Results:The AST and ALT were improved significantly in three groups after intervention(P<0.001).The variation of the TC,TG,HDL-c,LDL-c,ApoA and ApoB levels had no difference in three groups(P>0.05).Conclusion:In the treatment of patients with elevated transaminase after PCI treated with statin lipid-lowering therapy,the original dose of statin halving combined with lipidine can effectively improve liver function and continuously reduce lipid level,which is safe,effective and valuable.