强化他汀治疗对择期PCI患者冠脉无复流及血浆APN与炎性因子的影响  

Intensive atorvastatin therapy decreases plasma hs-CRP and increases plasma adiponectin in patients undergoing elective percutaneous coronary intervention

作　　者：常快乐[1] 王海昌[1] 廉坤[1] 贾敏[1] 刘毅[1] 马新亮[1] 陶凌[1] 

机构地区：[1]第四军医大学西京医院心血管内科,陕西西安710032

出　　处：《心脏杂志》2012年第2期189-192,共4页Chinese Heart Journal

基　　金：国家高技术研究发展计划项目资助(863计划;2009AA02乙104)

摘　　要：目的:观察强化他汀治疗对择期经皮冠状动脉介入治疗(PCI)患者术中出现无复流风险及其血浆脂联素(APN)、血清高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、炎性因子高敏C反应蛋白(hs-CRP)的影响。方法:70例择期PCI患者随机分为强化他汀组(强化组,n=35)及常规他汀组(常规组,n=35),强化组阿托伐他汀每日80 mg,2 d术前进行预处理,2 d后每日40 mg,服1月,常规组术前每日20 mg,2 d,术后长期服用。分别检测术前及术后1月、3月hs-CRP、HDL-C、LDL-C、APN;观察术中无复流的发生率;主要终点是30 d内的主要不良心脏事件(MACE;死亡,心肌梗死或计划外的血管重建)。结果:两组均未出现MACE,均无明显不良反应。1月后两组APN、HDL-C均有上升,强化组APN:(8±4)mg/L,常规组:(6±3)mg/L;强化组上升明显(P<0.05)。两组hs-CRP、LDL-C均有下降,强化组hs-CRP:(3.2±2.1)mg/L,常规组:(4.5±2.3)mg/L;强化组显著性下降(P<0.05);术前与术后比较差异有统计学意义(P<0.05)。强化组术中无复流3例,常规组5例,两组差异未达到统计学意义。结论:强化他汀治疗能够降低择期PCI患者血浆炎性因子水平,升高血浆APN水平。AIM： To investigate the effect of intensive atorvastatin therapy in patients undergoing percuta- neous coronary intervention （PCI）. METHODS： Seventy patients undergoing elective PCI were randomly divided into intensive atorvastatin therapy group （35 patients） and moderate atorvastatin therapy group （35 patients）. The patients in the intensive group were given atorvastatin （80 mg/day） for 2 days before PCI followed by 40 mg/day for 30 days after PCI. Patients in the moderate group were given atorvastatin （20 rag/day） for 2 days before PCI followed by 20 rag/day for 30 days after PCI. The 30-day incidence of major adverse cardiac events （MACE） and the incidence of slow flow/no reflow were recorded. Plasma levels of hs-CRP, HDL-C, LDL-C, adiponecfin （APN） and myocardial injury markers （CK-MB and cTnI） were tested in the two groups before as well as 1 and 3 months after PCI. RESULTS ： No occurrence of MACE and no severe adverse effects were found in the two groups. Plasma APN significantly increased and hs-CRP decreased in the intensive group compared with those in the moderate group [ APN： （8 ± 4） mg/Lvs. （6±3） mg/L; hs-CRP： （3.2±2.1） mg/Lvs. （4.5±2.3） mg/L, P〈0.05] alter 1 month. The incidence of slow flow/no reflow was 3/35 in intensive group and 5/35 in moderate group with no statistical significance between groups. CONCLUSION： Intensive atorvastatin therapy significantly decreases plasma hs-CRP and increases plasma adiponectin in patients undergoing elective PCI.

关 键 词：强化他汀治疗 脂联素 无复流现象 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]