不同剂量阿托伐他汀对老年稳定型心绞痛患者PCI术后炎症反应及预后的影响  

Effect of different doses of atorvastatin on inflammatory response and clinical prognosis in elderly patients with stable angina pectoris after percutaneous coronary intervention

作　　者：李伟光 王莹 刘培良 

机构地区：[1]辽宁省金秋医院心血管内科,沈阳110016

出　　处：《新医学》2015年第12期826-829,共4页Journal of New Medicine

摘　　要：目的比较不同剂量阿托伐他汀对老年稳定型心绞痛(SAP)患者PCI术后的炎症因子(内皮素-1和一氧化氮水平)影响,进一步探讨其对PCI术后再狭窄的干预效果。方法选择86例行PCI术老年SAP患者,分为双倍剂量组(40 mg/d,n=48)和常规剂量组(20 mg/d,n=38),2组均治疗12周。比较治疗前后2组患者的血脂、内皮素-1和一氧化氮水平。随访12个月,对比2组患者PCI术后再狭窄率和再住院率。结果治疗后,2组患者的LDL-C、内皮素-1水平均比治疗前明显降低、一氧化氮水平均比治疗前明显升高(P均<0.01);与常规剂量组相比,治疗后双倍剂量组LDL-C、内皮素-1水平更低,一氧化氮水平更高(P均﹤0.01)。双倍剂量组患者的支架再狭窄率和再住院率均明显低于常规剂量组(P均﹤0.05)。治疗期间,2组均未见明显不良反应。结论老年SAP患者应用双倍剂量的阿托伐他汀有更好的调脂及血管内皮保护作用,且安全性好。Objective To compare clinical effect of different doses of atorvastatin on the expression levels of inflammatory factors（ endothelin-1 and nitric oxide） and assess the intervention effect of different doses of atorvastatin on re-stenosis after percutaneous coronary intervention（ PCI） in elderly patients with stable angina pectoris（ SAP）. Methods Eighty six elderly patients with SAP receiving PCI were selected in this study and divided into the double dose（ 40 mg / d,n = 48） and conventional dose groups（ 20 mg / d,n = 38）for 12 weeks. Low density lipoprotein-cholesterol（ LDL-C）,endothelin-1 and nitric oxide were statistically compared between two groups before and after corresponding treatment. After 12-month follow-up,the re-stenosis and re-hospitalization rates after PCI were compared between two groups. Results LDL-C and endothelin-1levels were significantly decreased whereas nitric oxide level was considerably increased after treatment in two groups（ both P 0. 01）. Compared with the conventional dose group,LDL-C and endothelin-1 levels were statistically lower whereas nitric oxide level was significantly higher in the double dose group（ both P 0. 01）.The re-stenosis and re-hospitalization rates in the double dose group were both significantly lower than those in the conventional dose group（ both P 0. 05）. No apparent side effects were documented in two groups throughout the treatment. Conclusions Compared with conventional dose of atorvastatin,administration of double dose of atorvastatin yields higher efficacy in regulating blood lipid,protecting vascular endothelia and higher safety for elderly patients with SAP.

关 键 词：阿托伐他汀 老年稳定型心绞痛 内皮素-1 一氧化氮 

分 类 号：R541.4[医药卫生—心血管疾病]