不同剂量阿托伐他汀对冠心病冠状动脉搭桥术患者术后血脂和心功能的影响  

The effect of different doses of atorvastatin on cardiac function and lipid in the patients with coronary heart disease after coronary artery bypass grafting

作　　者：王平善[1] 

机构地区：[1]桂林医学院附属医院心胸外科,广西桂林300451

出　　处：《蚌埠医学院学报》2015年第6期746-748,共3页Journal of Bengbu Medical College

摘　　要：目的：观察冠心病冠状动脉搭桥术（ CABG）患者治疗前后应用不同剂量阿托伐他汀对术后血脂及心功能的影响。方法：将60例拟行CABG治疗的冠心病患者根据手术前后阿托伐他汀使用的剂量不同分为强化治疗组（40 mg/d）和常规治疗组（20 mg/d）各30例。比较2组患者治疗前后血脂及超声心动图检查结果，并记录用药期间不良反应。结果：强化治疗组治疗后总胆固醇、三酰甘油和低密度脂蛋白胆固醇降低程度及高密度脂蛋白胆固醇升高程度均优于常规治疗组（ P＜0.05-P＜0.01）。强化治疗组治疗后左心室收缩末期容积指数、左心室舒张末期容积指数和A峰降低程度及E峰、E/A与左心室射血分数升高程度均优于常规治疗组（P＜0.01）。强化治疗组总不良反应率为16.67%，常规治疗组为10.00%，差异无统计学意义（P〉0.05）。结论：冠心病CABG患者治疗前后应用阿托伐他汀强化治疗可显著调节血脂、改善心功能，效果优于常规剂量，且并不增加不良反应，安全有效。Objective：To explore the effects of different doses of atorvastatin on the cardiac function and lipid in the patients with coronary heart disease after coronary artery bypass grafting（ CABG） . Methods：Sixty patients with coronary artery disease scheduled by CABG were randomly divided into the intensive treatment group（40 mg/d） and conventional treatment group（20 mg/d） according to the dose of atorvastatn before and after the surgery（30 cases each group）. The blood lipid level and echocardiographic finding between two groups were compared before and after surgery,and the adverse reactions in two groups were recorded during treatment. Results：After treatment,the reduction of total cholesterol,triglyceride and low-density lipoprotein-cholesterol and increasing degree of high-density lipoprotein-cholesterol in intensive treatment group were better than those in conventional treatment group（P 〈0. 05 to P 〈0. 01）. After treatment,the reduction of left ventricular end systolic volume index,left ventricular end-diastolic volume index and A peak and increasing degree of E peak,E/A and left ventricular ejection fraction in intensive treatment group were better than those in conventional treatment group（P〈0. 01）. The adverse reaction rates in intensive treatment group and conventional treatment group were 16. 67% and 10. 00%,respectively,the difference of which was not statistically significant（P〉0. 05）. Conclusions：The application of atorvastatin in the treatment of the coronary heart disease patients treated with CABG before and after surgery can significantly regulate blood lipid and improve heart function,which does not increase adverse reactions,and is safe and effective.

关 键 词：冠心病 阿托伐他汀 冠状动脉搭桥术 血脂 心功能 

分 类 号：R541.4[医药卫生—心血管疾病]