强化阿托伐他汀治疗对急性冠状动脉综合征患者PCI术后血脂水平及长期预后的影响  

Influence of atorvastatin intensive treatment on blood lipid level and long-term prognosis of acute coronary syndrome patients after percutaneous coronary intervention

作　　者：姜宜成[1] 王中群[1] 徐海[1] 李江津[1] 张喜文[1] JIANG Yi-cheng WANG Zhong-qun XU Hai LI Jiang-jin ZHANG Xi-wen(Department of Cardiology, Huai＇an First People＇s Hospital, Jiangsu, Huai＇an 223300, Chin)

机构地区：[1]淮安市第一人民医院心内科,江苏淮安223300

出　　处：《中国医学前沿杂志（电子版）》2016年第11期37-40,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：江苏省自然科学基金项目(BK20131246)

摘　　要：目的研究强化阿托伐他汀治疗对急性冠状动脉综合征(acute coronary syndrome,ACS)患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后血脂水平及长期预后的影响。方法选取本院2013年1月至2015年2月拟行PCI的ACS患者120例为研究对象,按入院时间先后顺序将其随机分为观察组和对照组,每组各60例。两组患者入院后均予以常规治疗,对照组患者在常规治疗基础上加用阿托伐他汀钙治疗,观察组患者在常规治疗基础上加用强化阿托伐他汀钙治疗。比较两组患者治疗前及治疗1、3、6、12个月后,总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)、血清高敏C反应蛋白(high sensitivity C reactive protein,hs-CRP)、基质金属蛋白酶(matrix metalloproteinase-9,MMP-9)水平变化、预后及不良反应发生情况。结果治疗3、6、12个月后,观察组患者TC[(4.02±0.55)mmol/L、(3.81±0.51)mmol/L、(3.70±0.48)mmol/L]和LDL-C[(2.03±0.40)mmol/L、(1.97±0.31)mmol/L、(1.84±0.26)mmol/L]水平均明显低于对照组[TC:(4.31±0.70)mmol/L、(4.20±0.62)mmol/L、(4.15±0.51)mmol/L;LDL-C:(2.34±0.51)mmol/L、(2.30±0.47)mmol/L、(2.28±0.41)mmol/L](PTC分别为0.009,0.007,0.006;PLDL-C分别为0.012,0.005,0.002)。治疗3、6、12个月后观察组患者血清hs-CRP[(10.21±3.69)mg/L、(7.01±2.13)mg/L、(4.26±2.03)mg/L]和MMP-9[(123.0±54.2)μg/L、(89.7±32.1)μg/L、(110.3±33.6)μg/L]水平均明显低于对照组[hs-CRP:(15.24±6.23)mg/L、(11.78±4.12)mg/L、(9.36±2.26)mg/L;MMP-9:(189.7±96.5)μg/L、(120.2±98.4)μg/L、(156.2±51.2)μg/L](Phs-CRP分别为0.012,0.008,0.002;PMMP-9分别为0.001,0.001,0.001);两组患者上述指标与治疗前比较均具有显著差异(P<0.05)。随访1年,观察组患者不良心脏事件发生率[8.33%(5/60)]明显低于对照组[56.67%(34/60)](P=0.000)。观察�Objective To investigate the influence of atorvastatin intensive treatment on blood lipid level and long-term prognosis of acute coronary syndrome （ACS） patients after percutaneous coronary intervenrion （PCI）. Method 120 cases patients with ACS in our hospital from January 2013 to February 2015 were divided into observation group and control group, 60 cases in each group. Patients in control group were treated with conventional atorvastatin calcium therapy, and patients in observation group were treated with atorvastatin calcium therapy on the basis of routine treatment. The levels of total cholesterol （TC）, triglyceride （TG）, low density lipoprotein-cholesterol （LDL-C）, high density lipoprotein-cholesterol （HDL-C）, high sensitivity C reactive protein （hs-CRP）, matrix metalloproteinase-9 （MMP-9） and prognosis, adverse reactions of the two groups at 1, 3, 6, 12 months after PCI were evaluated and compared. Result The levels of TC and LDL-C of observation group [（4.02 ± 0.55） mmol/L, （3.81±0.51） mmol/L, （3.70± 0.48） mmol/L; （2.03 ±0.40） mmol/ L, （1.97± 0.31） mmol/L, （1.84 ± 0.26） mmol/L] were lower than those in control group [（4.31 ± 0.70） mmol/L, （4.20±0.62） mmol/L, （4.15± 0.51） mmol/L; （2.34 ± 0.51） mmol/L, （2.30±0.47） mmol/L, （2.28±0.41） mmol/L] （separately PTC = 0.009, 0.007, 0.006; separately PLDL-C = 0.012, 0.005, 0.002）. There were no significant difference in TG and HDL-C levels between the two groups befbre and after treatment （P 〉 0.05）. At 3, 6, 12 months after treatment, the levels of serum hs-CRP and MMP-9 of observation group [（10.21±3.69） mg/L, （7.01±2.13） rag/L, （4.26±2.03） mg/L; （123.0±54.2） lag/L, （89.7±32.1） lag/L, （110.3±33.6） lag/L] after treatment were significantly lower than those in control group [（15.24±6.23） mg/L, （11.78 ± 4.12） rag/L, （9.36±2.26） mg/L; （189.7±96.5） lag/L, （120.2±98.4） Bg/L, （156.2±51.2） lag/L] （separately Phs

关 键 词：阿托伐他汀 经皮冠状动脉介入治疗 急性冠状动脉综合征 血脂 预后 

分 类 号：R541.4[医药卫生—心血管疾病]