PCI术前高剂量阿托伐他汀钙对STEMI患者血清前白蛋白水平的影响  

Effect of high-dose atorvastatin treatment on serum prealbumin in STEMI patients before primary PCI

作　　者：王丹[1] 马增春[2] 李凯[1] 杨长春[1] 

机构地区：[1]北京武警总医院南楼一科,北京100039 [2]军事医学科学院放射与辐射医学研究所,北京100850

出　　处：《中国药物应用与监测》2015年第2期65-68,共4页Chinese Journal of Drug Application and Monitoring

基　　金：国家自然科学基金项目(81274127)

摘　　要：目的:探讨经皮冠状动脉介入术(PCI)术前80 mg阿托伐他汀钙治疗对急性ST段抬高型心肌梗死(STEMI)患者血清前白蛋白(PA)和高敏C反应蛋白(hs-CRP)的影响。方法:选取2013年2月–2014年2月于我院收治的12 h内需行紧急PCI术治疗的110例STEMI患者为急性心肌梗死组(AMI组),按照阿托伐他汀钙应用剂量不同,按照随机数字信封法将AMI组患者随机分成3组:A组(术后20 mg·d-1,n=38)、B组(术后40 mg·d-1,n=35)和C组(术前一次给予80 mg,术后40 mg·d-1,n=37),同时随机抽取同期健康体检患者40例为对照组。应用免疫透射比浊法检测AMI患者入院时,术后1 d、3 d血清PA水平,同时采用乳胶增强免疫比浊法测定hs-CRP水平。结果:与对照组比较,AMI组患者PA水平降低,hs-CRP水平升高,差异具有统计学意义(P<0.05);与术前相比,AMI组患者术后1 d、3 d血清PA水平呈持续性降低,同时伴随hs-CRP水平逐渐升高(P<0.05);A、B、C 3组组间比较,术前PA及hs-CRP水平均无统计学差异(P>0.05);术后1 d血清hs-CRP水平C组较B组降低,术后3 d C组较A组、B组进一步降低(P<0.05);术后3 d血清PA水平C组明显高于A组和B组(P<0.05)。结论:PCI术前高剂量阿托伐他汀钙通过上调STEMI患者血清PA水平,下调hs-CRP水平,发挥抗炎作用;血清PA有望成为STEMI患者疾病监测和药物治疗的标志物。Objective： To investigate the effect of early administration of high-dose atorvastatin （80 mg） on serum prealbumin and high sensitivity C-reactive protein （hs-CRP） in acute ST segment elevation myocardial infarction （STEMI） patients treated with percutaneous coronary intervention （PCI）. Methods：A total of 110 STEMI patients undergoing emergency PCI in 12 hours admitted to our hospital from February 2013 to February 2014 were enrolled in this study. According to the random digital envelope method, acute myocardial infarction （AMI） patients were randomly divided into group A （n=38, no atorvastatin preoperation and 20 mg·d^-1 postoperation）, group B （n=35, no atorvastatin preoperation and 40 mg·d^-1 postoperation） and group C （n=37, 80 mg atorvastatin preoperation and 40 mg·d^-1 postoperation）. Other 40 healthy cases were recruited in control group. The levels of serum prealbumin of AMI patients when admitted to hospital, 1 d and 3 d after PCI were measured by immunohistochemical nephelometry method. At the same time latex-enhanced turbidimetric immunoassay was applied to detect the level of hs-CRP. Results：Compared with the control group, the level of hs-CRP were significantly higher and serum prealbumin were lower in AMI patients （P〈0.05）;compared with before PCI, serum hs-CRP levels in AMI patients were signiifcantly higher on 1 d and 3 d after PCI. While serum prealbumin decreased gradually （P〈0.05）;there were no signiifcant differences in serum hs-CRP and prealbumin levels before PCI among three subgroups. Compared with group B, hs-CRP levels was lower in group C at 1 d after PCI, and hs-CRP levels in group C was further reduced. Three days after operation, serum PA comparatively increased compared with group A and group B （P〈0.05）. Conclusion：High-dose atorvastatin before primary PCI in STEMI patients can decrease hs-CRP levels and raise serum prealbumin levels. It is beneift to alleviate inlfammatory reactions. Serum prealbumin may be a useful bioma

关 键 词：急性ST段抬高型心肌梗死 阿托伐他汀钙 前白蛋白 高敏C反应蛋白 

分 类 号：R542.22[医药卫生—心血管疾病]