【摘要】：目的:探討不同劑量阿托伐他汀預處理對行經(jīng)皮冠狀動脈介入治療(PCI)的非ST段抬高型急性冠脈綜合征(NSTEACS)患者的保護作用。方法:選取2014年1月-2016年4月某院收治的NSTE-ACS患者81例,按隨機數(shù)字表法分為高劑量組(40例)和低劑量組(41例)。高劑量組患者在PCI術前12～24 h給予阿托伐他汀鈣片80 mg,術前2 h再給予40 mg;低劑量組患者在PCI術前12～24 h給予阿托伐他汀鈣片10 mg。觀察兩組患者術后血流儲備分數(shù)(FFR)、冠脈血流儲備分數(shù)(CFR)和微循環(huán)阻力指數(shù)(IMR),比較兩組患者手術前后肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)和高敏感性C反應蛋白(hs-CRP)水平。結果:兩組患者術后FFR、CFR比較,差異無統(tǒng)計學意義(P0.05);高劑量組患者術后IMR顯著低于低劑量組,差異有統(tǒng)計學意義(P0.05)。兩組患者術前CK、CK-MB和CRP水平比較,差異無統(tǒng)計學意義(P0.05);術后,低劑量組患者CK-MB和CRP水平顯著升高,且顯著高于高劑量組,差異均有統(tǒng)計學意義(P0.05);兩組患者術后CK水平比較,差異無統(tǒng)計學意義(P0.05)。兩組患者均未見明顯不良反應發(fā)生。結論:在實施PCI術前,對NSTE-ACS患者預先使用高劑量阿托伐他汀(80→40 mg)可顯著改善患者微循環(huán)障礙,同時抑制炎癥反應。
[Abstract]:Objective: to investigate the protective effect of different doses of Atto statins on (NSTEACS) patients with non-ST segment elevation acute coronary syndrome (NSTEACS) treated with percutaneous coronary intervention (PTCA). Methods: from January 2014 to April 2016, 81 patients with NSTE-ACS were randomly divided into high dose group (n = 40) and low dose group (n = 41). Patients in the high dose group were given Atto Vastatin calcium tablets at 12: 24 h before PCI, 80 mg, before operation, and then 40 mg; at 12: 24 h before PCI. The patients in the low dose group were given 10 mg. at 12: 24 h before PCI. The levels of creatine kinase (CK), creatine kinase isoenzyme (CK-MB) and high sensitivity C-reactive protein (hs-CRP) were compared between the two groups before and after operation. The coronary flow reserve fraction (CFR) and microcirculatory resistance index (IMR),) were compared between the two groups. Results: there was no significant difference in postoperative FFR,CFR between the two groups (P 0.05), but the postoperative IMR in the high dose group was significantly lower than that in the low dose group (P 0.05). There was no significant difference in the levels of CK,CK-MB and CRP between the two groups before operation (P 0.05). After operation, the levels of CK-MB and CRP in the low dose group were significantly higher than those in the high dose group (P 0.05). There was no significant difference in the level of CK between the two groups (P 0.05). No obvious adverse reactions were found in both groups. Conclusion: before PCI, the pre-treatment of high dose Atto varastatin (80 mg) can significantly improve the microcirculatory disturbance and inhibit the inflammatory response in patients with NSTE-ACS.
【作者單位】： 解放軍第464醫(yī)院心內(nèi)科;
【分類號】：R541.4

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