不稳定心绞痛患者术前给予不同剂量阿托伐他汀对PCI术后心肌损伤的影响

Effects of myocardial injury of different doses of atorvastatin in unstable angina pectoris patients after PCI

目的 :探讨经皮冠状动脉介入(PCI)术前24h内给予负荷剂量(80mg)阿托伐他汀对不稳定心绞痛患者PCI术后心肌损伤的影响。方法 :将200例需经PCI治疗不稳定心绞痛患者根据随机数字表法分为观察组和对照组,观察组术前应用80mg阿托伐他汀,对照组术前给予20mg阿托伐他汀。比较两组肌钙蛋白、B型脑钠肽前体(NT-pro BNP)、高敏C-反应蛋白(Hs-CRP)、肌酸激酶同工酶(CK-MB)水平变化情况以及患者术后1月内随访不良心血管事件发生率。结果 :(1)两组患者手术后心肌肌钙蛋白、NT-pro BNP、Hs-CRP、CK-MB水平明显高于手术前,差异有统计学意义,观察组上述指标明显低于对照组,差异有统计学意义;(2)观察组心源性再住院、心绞痛复发发生率及心血管事件总发生率均明显低于对照组,差异均有统计学意义。结论 :PCI术前应用负荷剂量阿托品能够有效的降低PCI术后心肌损伤,并能够降低患者心血管事件发生率。

Objective To study the percutaneous coronary intervention (PCI) in the preoperative 24h loading dose (80mg) of atorvastatin on patients with unstable angina pectoris myocardial injury after PCI operation. Method 200 patients required by PCI in the treatment of unstable angina pectoris patients were divided into observation group and control group according to randomly number table, the observation group were treated with 80mg atorvastatin, The control group were given 20mg of atorvastatin. troponin, B pro brain natriuretic peptide (NT-proBNP), Gao Min C- reactive protein (Hs-CRP), creatine kinase isoenzyme (CK-MB) changes of two groups were compared. The incidence of postoperative adverse cardiovascular events was followed 1 mounth after PCI. Results the operation of cardiac troponin, NT-proBNP, Hs-CRP, CK-MB levels of the two groups were significantly higher than that before operation, the difference was statistically significant,The above indexes of observa-tion group was significantly lower than that of control group, The difference was statistically significant; the incidence of cardiac readmission, Recurrence of angina and cardiovascular events of the observation group were significantly lower than the control group, The differences were statistically significant. Conclusion loading dose of atropine can effectively reduce myocardial damage after PCI, and can reduce the incidence of cardiovascular events.