不同剂量他汀对冠心病CABG围术期病人血清心肌损伤标志物影响  

EFFECTS OF DIFFERENT DOSES OF STATIN ON SERUM CARDIAC INJURY MARKERS IN PERIPROCEDURAL PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFTING

作　　者：宇毅[1] 刘松[2] 程华伟[1] 张萌萌[1] 

机构地区：[1]青岛大学附属医院心血管外科,山东青岛266003 [2]青岛大学附属医院心血管内科,山东青岛266003

出　　处：《青岛大学医学院学报》2015年第4期457-459,共3页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：目的探讨冠状动脉旁路移植术（CABG）围术期不同剂量他汀治疗对冠心病病人血清心肌损伤标志物的影响。方法选取行非停搏CABG冠心病病人78例,随机分为观察组40例和对照组38例,观察组于CABG术前12h及术后30d内每天给予40mg阿托伐他汀治疗,对照组术前及术后30d内每天均给予10mg阿托伐他汀治疗。比较两组术前12h与术后6、12h肌钙蛋白（cTnI）、肌酸激酶同工酶（CK-MB）水平,及术后1、7、14、30d高敏C反应蛋白（hs-CRP）的变化。结果两组病人术前cTnI、CK-MB、hs-CRP水平比较,差异无显著意义（t=0.331~0.590,P〉0.05）。术后各时间点两组病人的cTnI、CK-MB、hs-CRP水平较术前明显升高,差异有统计学意义（F=4.885~8.120,P〈0.05）;观察组术后各时间点cTnI、CK-MB、hs-CRP水平均较对照组低,差异有显著意义（t=1.852~22.944,P〈0.05）。结论 CABG围术期给予大剂量他汀治疗,可以降低炎症反应,减少心肌损伤。Objective To explore the effects of different doses of statin therapy on serum cardiac injury markers in perioperative patients undergoing coronary artery bypass grafting（CABG）. Methods Seventy-eight patients undergoing off-pump CABG were randomized to observation group（n=40）and control group（n=38）.Patients in the observation group took 40 mg atorvastatin,once a day,starting from 12 hours before surgery to within 30 days after surgery,and those in the control group took10 mg of atorvastatin,once a day,before and within 30 days after surgery.The levels of Troponin I（cTnI）and creatine kinase MB isoenzyme（CK-MB）-12 hbefore,6hand 12 hafter CABG-and serum high sensitivity C-reactive protein（hs-CRP）-1,7,14 d and 30 dafter CABG-were compared between the two groups. Results Before surgery,the differences of levels of cTnI,CKMB,and hs-CRP between the two groups were not statistically significant（P0.05）.After surgery,the levels of the above parameters at each time period were significantly elevated versus before surgery（F=4.885-8.120,P0.05）,and the levels of the above parameters in the observation group at each time period were lower than that in the control group,the differences were statistically significant（t=1.852-22.944,P0.05）. Conclusion High-dose statin therapy during peri-CABG can reduce inflammatory reaction and decrease myocardial damage.

关 键 词：冠心病 冠状动脉旁路移植术 非体外循环 阿托伐他汀 

分 类 号：R541.4[医药卫生—心血管疾病]