不同剂量阿托伐他汀预处理对经皮冠状动脉介入治疗患者的保护作用  

Protective Effects of Different Doses of Atorvastatin Pretreatment on Patients Underwent Percutaneous Coronary Intervention

作　　者：丁胜华 仵淑娟 郑立娇 

机构地区：[1]解放军第464医院心内科,天津300381

出　　处：《中国药房》2017年第35期4987-4989,共3页China Pharmacy

摘　　要：目的:探讨不同剂量阿托伐他汀预处理对行经皮冠状动脉介入治疗(PCI)的非ST段抬高型急性冠脉综合征(NSTEACS)患者的保护作用。方法:选取2014年1月-2016年4月某院收治的NSTE-ACS患者81例,按随机数字表法分为高剂量组(40例)和低剂量组(41例)。高剂量组患者在PCI术前12～24 h给予阿托伐他汀钙片80 mg,术前2 h再给予40 mg;低剂量组患者在PCI术前12～24 h给予阿托伐他汀钙片10 mg。观察两组患者术后血流储备分数(FFR)、冠脉血流储备分数(CFR)和微循环阻力指数(IMR),比较两组患者手术前后肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)和高敏感性C反应蛋白(hs-CRP)水平。结果:两组患者术后FFR、CFR比较,差异无统计学意义(P>0.05);高剂量组患者术后IMR显著低于低剂量组,差异有统计学意义(P<0.05)。两组患者术前CK、CK-MB和CRP水平比较,差异无统计学意义(P>0.05);术后,低剂量组患者CK-MB和CRP水平显著升高,且显著高于高剂量组,差异均有统计学意义(P<0.05);两组患者术后CK水平比较,差异无统计学意义(P>0.05)。两组患者均未见明显不良反应发生。结论:在实施PCI术前,对NSTE-ACS患者预先使用高剂量阿托伐他汀(80→40 mg)可显著改善患者微循环障碍,同时抑制炎症反应。OBJECTIVE： To investigate protective effects of different doses of atorvastatin pretreatment on non-ST-segment elevation acute coronary syndrome （NSTE-ACS） patients underwent percutaneous coronary intervention （PCI）. METHODS： A total of 81 NSTE-ACS patients in a hospital during Jan. 2014-Apr. 2016 were divided into high-dose group （40 cases） and low dose group （41 cases） according to random number table. High-dose group was given Atorvastatin calcium tablet 80 mg 12-24 h before PCI, and then 40 mg 2 h before PCI. Low-dose group was given Atorvastatin calcium tablet 10 mg 12-24 h before PCI. Fractional flow reserve （FFR）, coronary flow reserve （CFR） and index of microcirculation resistance （IMR） after surgery were all observed in 2 groups. The levels of creatine kinase （CK）, creatine kinase myocardial band （CK-MB） and high sensitive C-reactive protein （hs-CRP） were compared between 2 groups before and after surgery. RESULTS： There was no statistical signifi- cance in FFR and CFR after surgery between 2 groups （P〉0.05） ; IMR of high-dose group was significantly lower than low-dose group, with statistical significance （P〈0.05）. There was no statistical significance in CK, CK-MB or CRP between 2 groups before surgery （P〉0.05）. After surgery, the levels of CK-MB and CRP in low-dose group were significantly higher than high-dose group, with statistical significance （P〈0.05）. There was no statistical significance in CK level between 2 groups after surgery （P〉0.05）. No obvious ADR was found in 2 groups. CONCLUSIONS： During PCI, pre-treatment with high-dose of atorvastatin （80→40 mg） could effectively improve microcirculatory disturbance and inhibit inflammatory reaction of NSTE-ACS patients.

关 键 词：急性冠脉综合征 经皮冠状动脉介入治疗 阿托伐他汀 剂量 

分 类 号：R453.9[医药卫生—治疗学]