摘要
目的探讨经皮冠状动脉介入治疗（PCI）围术期应用不同剂量阿托伐他汀对急性冠状动脉综合征（ACS）患者预后的影响。方法选取78例ACS患者为研究对象，随机抽样法分成研究组（n=39）和对照组（n=39）。均口服阿托伐他汀片治疗，对照组术前1h口服阿托伐他汀片20mg／d＋术后维持20mg／d，治疗30d；研究组术前1h口服阿托伐他汀片40mg/d＋术后维持40mg／d，治疗30d。比对两组围术期脂质生化指标及超敏c反应蛋白（hs-CRP）等指标变化情况，记录其不良反应发生率及随访期心血管事件发生率。结果（1）PCI后1个月时，除对照组TG水平较PCI前无明显改善（P〉0．05）外，两组TC、HDL-C、LDL-C及hsCRP等生化指标均较PCI前显著降低（P〈0．05）；其中研究组各指标降幅显著大于对照组（P〈0．05）。（2）研究组轻微不良反应发生率为15．8％，对照组12．8％，差异无统计学意义（P〉0．05）。（3）PCI后1个月内，两组心血管事件发生率对比，差异无统计学意义（P〉0．05）；PCI后1年内，研究组心血管事件发生率为17．9％，显著低于对照组的41．0％（P〈0．05）。结论PCI围术期内予以高削量阿托伐他汀片口服治疗方案，降脂效果显著，对改善炎症反应、降低心血管事件发生风险、提升患者预后等具有积极意义。
Objective To investigate the effects of different doses of atorvastatin during perioperative period of percutaneous coronary intervention （PCI） on the prognosis of patients with acute coronary syndrome （ACS）. Methods 78 ACS patients were selected as study objects and were randomly divided into a study group （n=39） and a control group （n=39）. The control group orally took atorvastatin tablets 20 mg 1 h before the operation and took a maintenance dose of 20 mg/d for 30 d after the operation and the study group 40 mg and 40 mg/d. The changes of lipid biochemical indexes and high sensitive C reactive protein （hs-CRP）, etc. during perioperative period were compared between these two groups. The differences in the incidences of adverse reactions and cardiovascular events between these two groups in the follow-up period were recorded. Results One month after PCI, TG level in the control group was not significantly improved, compared with that before PCI （P〉0.05）. The biochemical indexes, such as TC, HDL-C, LDL-C and hs-CRP, in both groups were significantly lower than those before PCI （P〈0.05）; The decreasing ranges of the indexes in the study group was significantly greater than those in the control group （P〈0.05）. （2） The incidence of mild adverse reactions was 15.8% in the study group and was 12.8% in the control group （P〉0.05）. （3） Within one month after PCI, there was no statistical difference in the incidence of cardiovascular events between these two groups （P〈0.05）; within one year after PCI, the incidence of cardiovascular events was significantly lower in the study group than in the control group （17.9% vs. 41.0%, P〈0.05）. Conelusions Orally taking a high dose of atorvastatin tablets during the perioperative period of PCI is significantly effective in lowering lipid levels. It has positive significance in improving inflammatory reactions, reducing the risk of cardiovascular events, and improving of prognosis.
出处
《国际医药卫生导报》
2016年第10期1426-1429,共4页
International Medicine and Health Guidance News
