本文選題：阿托伐他汀 + 心臟病��； 參考：《河北醫(yī)科大學》2015年碩士論文

【摘要】：目的:本研究通過觀察術前應用阿托伐他汀對冠心病患者非心臟手術圍手術期心血管死亡率的影響,旨在指導心臟病患者非心臟手術圍手術期用藥。方法:選擇2013-12~2014-12在河北省四院的非心臟手術的心臟病患者,入選200例。其中試驗組96例,對照組104例。采用隨機數(shù)字表隨機分為兩個組,試驗組與對照組。排除標準:口服藥物困難患者;活動性肝病或原因不明的轉氨酶持續(xù)升高患者;近期新發(fā)生腦出血患者;高危手術患者;對阿托伐他汀過敏者;術中出現(xiàn)其他由于手術本身意外導致心臟并發(fā)癥。在常規(guī)治療基礎上,術前7天開始給予口服阿托伐他汀(輝瑞制藥有限公司,商品名:立普妥,國藥準字H20051407)20mg/次,每日1次。對照組不給藥。為了使患者依從性更好,入選患者出院后進行電話隨訪。由專人負責,對心臟病人非心臟手術圍手術期血壓、脈搏、心電監(jiān)護、中心靜脈壓監(jiān)測,觀察心電圖ST-T變化,隨訪術后心血管事件發(fā)生率(監(jiān)測血壓、心電圖、心臟彩超變化)以及圍術期心梗、心絞痛、房顫、室早、腎衰竭、血脂、心性死亡率,由專人記錄。所有患者資料均用光盤保存,用于前后對比。結果:試驗組房顫、室早發(fā)生率低于對照組,差異有統(tǒng)計學意義(P0.05)。觀察組治療后甘油三脂(TG)、總膽固醇(TC)低于對照組,但P0.05,無統(tǒng)計學差異。結論:口服阿托伐他汀,20mg/次,每日1次,能有效穩(wěn)定冠心病患者非心臟手術治療過程中心律失常等不良心臟事件。其作用機制可能與阿托伐他汀能有效降低血脂水平,抑制炎癥反應,減輕炎癥反應對心肌細胞損傷有關。
[Abstract]:Objective: to investigate the effect of preoperative Atto vastatin on perioperative cardiovascular mortality in patients with coronary heart disease (CHD). Methods: 200 patients with non-cardiac heart disease were selected from the fourth Hospital of Hebei Province in 2013-12 and 2014-12. There were 96 cases in the test group and 104 cases in the control group. Two groups were randomly divided into two groups: the experimental group and the control group. Exclusion criteria: patients with oral difficulty with drugs; patients with active liver disease or elevated transaminase with unknown cause; patients with recent new cerebral hemorrhage; patients with high-risk surgery; patients allergic to Atto; There were other cardiac complications due to the operation itself. On the basis of routine therapy, oral Atto vastatin was given 7 days before operation (Pfizer Pharmaceutical Co., Ltd., trade name: Lipitor, H20051407)20mg/ times of Chinese medicine, once a day. The control group was not administered. In order to improve compliance, the selected patients were followed up by telephone after discharge. The blood pressure, pulse, ECG monitoring, central venous pressure monitoring, ST-T changes, cardiovascular events (monitoring blood pressure, electrocardiogram) in patients with non-cardiac surgery were observed. Myocardial infarction, angina pectoris, atrial fibrillation, ventricular premature, renal failure, blood lipid, cardiac death rate, recorded by special person. All patient data were saved on CD for comparison before and after. Results: the incidence of atrial fibrillation and ventricular premature in the trial group was lower than that in the control group (P 0.05). The levels of TGG and TC in the observation group were lower than those in the control group, but there was no significant difference between the two groups (P 0.05). Conclusion: oral administration of Atto vastatin 20 mg / time once a day can effectively stabilize arrhythmia and other adverse cardiac events in patients with coronary heart disease during non-cardiac surgery. The mechanism may be related to the effect of Atto vastatin on reducing blood lipid level, inhibiting inflammatory response and alleviating the injury of myocardial cells.
【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R541;R619

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