强化他汀治疗对合并睡眠呼吸暂停综合征的冠心病患者PCI术后的影响  

Effect of intensive statin therapy on patients with sleep apnea syndrome and coronary heart disease after percutaneous coronary intervention

作　　者：王前胜[1] 王艳伟[2] 刘东亮[1] 胡新荣[1] 蔡继锐[1] 

机构地区：[1]漯河市中心医院(漯河医学高等专科学校附属第一医院)心内科,河南漯河462002 [2]漯河医学高等专科学校病理教研室,河南漯河462000

出　　处：《实用药物与临床》2017年第7期763-766,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的研究不同剂量阿托伐他汀对合并睡眠呼吸暂停综合征的冠心病患者PCI术后的影响。方法将PCI术后的冠心病患者依据多导睡眠呼吸监测结果随机分为不合并睡眠呼吸暂停综合征组(对照组,90例)及合并睡眠呼吸暂停综合征组(SAS组,90例),之后再依据阿托伐他汀应用剂量,分别随机分为10 mg、20 mg、40 mg剂量组各30例;分别检测两组患者C反应蛋白(CRP)及白细胞介素-6(IL-6)水平;随访6个月内各剂量组心血管事件发生例数;PCI术后6个月复查冠脉造影,利用Gensini评分系统,分别对各剂量组患者进行冠状动脉病变程度评分。结果入院时,SAS组患者的CRP及IL-6水平高于对照组;PCI术后6个月,SAS 10 mg、20 mg剂量组CRP、IL-6水平高于对照组(P<0.05)。随访6个月后,SAS 10 mg、20 mg剂量组心绞痛、心力衰竭、心律失常发生例数多于对照组(P<0.05),但40 mg剂量组间比较差异无统计学意义(P>0.05);此外,SAS组患者的心血管事件发生率随着阿托伐他汀剂量的增大逐渐降低,且不同剂量组间差异有统计学意义(P<0.05);PCI术后6个月时,SAS组10 mg、20 mg组患者的Gensini积分较对照组明显偏高(P<0.05),但40 mg剂量组间比较差异无统计学意义(P>0.05)。结论强化他汀治疗可以降低合并睡眠呼吸暂停综合征冠心病患者PCI术后的炎症因子水平及心血管事件发生率,同时可以有效降低冠状动脉的病变程度。Objective To study the effects of different doses of atorvastatin on patients with sleep apnea syn- drome and coronary heart disease after percutaneous coronary intervention（PCI）. Methods The patients with coronary heart disease after PCI were randomly divided into without-sleep-apnea-syndrome group （ control group, n = 90 ） and with-sleep-apnea-syndronae group （ SAS group, n = 90 ） based on polysomnography monitoring results. Then, the pa- tients were randomly divided into 10 nag-, 20 nag-, and 40 rag-dose groups （n = 30） based on the doses of atorvastatin. The levels of C reactive protein （CRP） and interleukin-6 （IL-6） in each dose group were detected. The incidence of cardiovascular events in each dose group of two groups were followed up for 6 months. Coronary angiography was per- formed 6 months after PCI and Gensini score system was used to evaluate the severity of coronary artery lesion in each group. Results The CRP and IL-6 levels of SAS group at admission and at the dose of 10 nag and 20 nag were signifi- cantly higher than those of control group （ P 〈 0.05 ）, but there was no significant difference between SAS group and control group at the dose of 40 nag （ P 〉 0.05 ）. After follow-up of 6 months, the number of patients with angina pecto- ris,heart failure and arrhythmia in 10 nag and 20 mg dose groups of SAS group were significantly higher than that of control groups （ P 〈 0.05 ）, but there was no significant difference in the incidence of cardiovascular events between the 40 mg group （ P 〉 0. 05 ）. In addition, the incidence of cardiovascular events in patients of SAS group decreased gradu- ally with the increase of atorvastatin dose, and there was significant difference between different doses （ P 〈 0.05 ）. Six months after PCI, the Gensini score of patients in SAS group was significantly higher than that of control group at the dose of 10 mg and 20 mg （ P 〈 0. 05 ）, but there was no significant difference in Gensini score between the 40 mg

关 键 词：阿托伐他汀 睡眠呼吸暂停综合征 冠心病 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病] R766[医药卫生—内科学]