老年ACS患者PCI围手术期强化他汀治疗对心肌的保护作用和安全性  

Intensive statin therapy in the aged during perioperative period of PCI

作　　者：吴文利[1] 梅霞[1] 罗羽慧[1] 王骄[1] 

机构地区：[1]重庆市中山医院心内科,400013

出　　处：《重庆医学》2010年第20期2759-2760,2762,共3页Chongqing medicine

摘　　要：目的探讨在经皮冠状动脉成形技术(PCI)围手术期的老年急性冠状动脉综合征(ACS)患者中,接受不同剂量阿托伐他汀(立普妥)治疗,PCI术后6 h和12 h测定CK-MB升高大于3倍上限的患者比例,以及围手术期患者不良心脏事件的发生率及用药安全性。方法选择围手术期PCI术ACS患者90例,男59例,女31例,年龄(72±10.6)岁,随机分成A、B两组。A组(45例)入院服用阿托伐他汀80 mg,术前2 h再服40 mg,术后6 h和12 h测定CK-MB升高大于3倍上限的患者比例。B组(45例)入院服用阿托伐他汀20 mg,术前不给药,术后6 h和12 h测定CK-MB升高大于3倍上限的患者比例。两组患者围手术期心脏事件的发生率及其hs-CRP、AST、ALT的变化。结果 A组患者术后6 h和12 h CK-MB升高大于3倍上限的患者比例分别为15.6%(7/45)和9.0%(4/45),B组患者术后6 h和12 h CK-MB升高大于3倍上限患者比例分别为22.2%(10/45)和17.8%(8/45),A、B两组比较差异有统计学意义(P<0.05)。A、B组患者围手术期心脏不良事件发生率分别为4.4%(2/45)和11.1%(5/45)(P<0.05),差异有统计学意义。A组患者术后hs-CRP的浓度较术前降低,差异有统计学意义(P<0.05),而B组术前、术后hs-CRP的浓度无显著性差异。两组术前、术后ALT及AST浓度无显著性差异。结论老年ACS患者PCI围手术期强化他汀治疗安全性强,且心脏不良事件发生率明显降低。Objective Patients in PCI perioperative period were administrated different dose of atorvastatin（Lipitor）.Observed the incidence rate of increasing level of CKMB which is larger than three times top limit,and estimated safety of atorvastatin（Lipitor）.Methods Patients were randomly divided into 2 groups,group A was administrated by atorvastatin（Lipitor） 80mg when hospitalization,then 40mg before PCI;group B was only administrated by atorvastatin（Lipitor） 20mg when hospitalization.Level of CKMB,hs-CRP,AST and ALT was determinated and compared 6h and 12h after PCI.The major adverse cardiac events（MACE）occurrence post PCI was assessed.Results Level of CKMB in group A elevated larger than three times top limit was respectively 16.7 % and 10.0% when determinated 6h and 12h after PCI.While in group B was respectively 23.3% and 16.4%.There were obviously differences between two groups.The concentration of hs-CRP postop.decreased in Group A（P〈0.05）,but no difference in Group B（P〉0.05）.And there were no differences in the concentration of ALT and AST between two groups.MACE occurrence post PCI in Group A was 4.4%,while in Group B was 11.1%（P〈0.05）.Conclusion Intensive treatment of atorvastatin in PCI perioperative period is beneficial and safty.

关 键 词：阿托伐他汀 PCI围手术期 冠状动脉硬化 老年人 

分 类 号：R541.4[医药卫生—心血管疾病]