PCI围术期阿托伐他汀序贯疗法的临床疗效评价  

Clinical study of perioperative PCI atorvastatin sequential therapy

作　　者：李维军[1] 潘家华[2] 

机构地区：[1]郴州市第一人民医院老年科,湖南郴州423000 [2]昆明医科大学第一附属医院心内科,云南昆明650000

出　　处：《湘南学院学报（医学版）》2015年第1期13-17,共5页Journal of Xiangnan University（Medical Sciences）

摘　　要：目的探讨阿托伐他汀序贯治疗在预防PCI围术期患者心肌损伤及降低不良心脏事件的作用。方法将90例接受PCI术的冠心病患者随机分成阿托伐他汀序贯治疗组(44例,入院即予以口服阿托伐他汀80 mg/d,术前2 h追加阿托伐他汀40 mg,术后第1个月阿托伐他汀40 mg/d,1月后改为阿托伐他汀20 mg/d长期维持)和常规治疗组(46例,入院至PCI术后长期阿托伐他汀20 mg/d维持)。主要观察指标是PCI术后30 d内的主要不良心脏事件(心源性死亡,心肌梗死,非计划的再次血运重建)发生率。次要观察指标是两组患者手术前后CK-MB及c Tn I水平。结果阿托伐他汀序贯治疗组较常规组的主要不良心脏事件发生率显著降低(9.1%vs 23.9%,P=0.025)。两组患者术前、术后CK-MB水平差异无统计学意义(P>0.05)。阿托伐他汀序贯治疗组术后c Tnl水平较术前显著降低(P<0.05),而常规治疗组术前、术后差异无统计学意义(P>0.05)。术后所有主要不良心脏事件均发生于PCI术后心肌坏死标记物升高的患者。结论围术期阿托伐他汀序贯治疗能显著降低择期PCI围术期患者的临床主要不良心脏事件。Objective To investigate whether an atorvastatin Sequential therapy of periprocedural percutaneous coronary intervention protects patients from periprocedural myocardial damage and incidence of major adverse cardiac events. Methods A total of 90 patients undergoing PCI were randomly divided into atorvastatin Sequential therapy group（ 80 mg / d before intervention,with a further 40-mg pre-procedural dose,40 mg / d postoperative after the first month,20 mg / d from the scondery month to long-term maintain n = 44）and atorvastatin Routine therapy group（ 20 mg / d From the hospital to long-term maintain,n = 46）. The main outcome measure was 30-day incidence of major adverse cardiac events（ cardiac death,myocardial infarction,or unplanned revascularization）. The scondery outcome measure was level of CK-MB and c Tnl.Results Adverse cardiac events in atorvastatin Sequential therapy group（ 9. 1%） is significantly lower than that in atorvastatin Sequential therapy group（ 23. 9%）（ P = 0. 025）. Two groups of patients before and after operation has no significant change in CK-MB level,namely（ P〈 0. 05）. The level of c Tnl before and after operation decreased significantly in atorvastatin Sequential therapy group（ P〈 0. 05） and has no significant difference in the atorvastatin Routine therapy group（ P〈 0. 05）. The adverse cardiac events after PCI occurred in patients with the increased myocardial necrosis markers. Conclusion Perioperative PCI atorvastatin sequential therapy can reduce the adverse cardiac events remarkably in the patients undergoing PCI.

关 键 词：冠心病 经皮冠状动脉介入治疗 阿托伐他汀 序贯疗法 围术期心肌梗死 

分 类 号：R541.4[医药卫生—心血管疾病]