阿托伐他汀序贯疗法对择期PCI治疗患者降脂和抗炎作用的疗效  

Lipid-lowering and anti-inflammatory effect of atorvastatin sequential therapy on patients undergoing selective PCI

作　　者：熊小栓 曾繁芳[2] 陈娟 王洪生 XIONG Xiao-shnan;ZENG Fan-fang;CHEN Juan;WANG Hong-sheng(Department of Cardiology,People＇s Hospital of Yantian District,Shenzhen,Guangdong,518081,China)

机构地区：[1]深圳市盐田区人民医院心内科,广东深圳518081 [2]深圳市孙逸仙心血管医院内科二病区

出　　处：《心血管康复医学杂志》2018年第4期440-444,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨阿托伐他汀(立普妥)序贯疗法对择期经皮冠状动脉介入治疗(PCI)患者降脂和抗炎作用。方法:94例择期冠心病PCI患者被随机分为常规治疗组(47例,入院至PCI术后长期口服阿托伐他汀20mg/d维持治疗)和序贯疗法组(47例,入院后口服阿托伐他汀80mg/d,术前4h再次口服阿托伐他汀40mg,术后40mg/d口服1个月后改为20mg/d,长期维持),比较两组用药前、用药后3d及3个月的血脂及炎性因子水平。结果:与治疗前比较,治疗后3d、3个月两组患者的TC、LDL-C、hsCRP、髓过氧化物酶(MPO)和基质金属蛋白酶-9(MMP-9)水平均明显下降(P<0.05或<0.01);且与常规治疗组比较,序贯治疗组治疗后3d和3个月的TC[3d:(4.16±1.04)mmol/L比(3.57±0.81)mmol/L,3个月:(3.36±1.01)mmol/L比(3.17±0.64)mmol/L]、LDL-C[3d:(2.23±0.54)mmol/L比(1.86±0.57)mmol/L,3个月:(1.89±0.58)mmol/L比(1.52±0.37)mmol/L]、hsCRP[3d:(7.42±2.75)mg/L比(5.35±1.94)mg/L,3个月:(2.57±0.31)mg/L比(1.89±0.18)mg/L]和MMP-9[3d:(859.45±221.36)pg/ml比(672.59±213.62)pg/ml,3个月:(675.75±141.63)pg/ml比(437.96±114.38)pg/ml]水平降低更显著(P均<0.01)。两组的药物不良反应和心血管不良事件发生率差异不显著(P均>0.05)。结论:阿托伐他汀常规和序贯疗法均能有效降低择期PCI术后患者的血脂和炎症因子水平,而序贯疗法降脂和抑制炎症因子的效果优于常规治疗。Objective： To explore lipid-lowering and ant-inflammatory effects of atorvastatin （Lipitor） sequential therapy on patients undergoing selective percutaneous coronary intervention （PCI）. Methods： A total of 94 patients with coronary heart disease （CHD） undergoing selective PCI were randomly divided into routine treatment group （n= 47, received maintenance treatment of atorvastatin 20mg/d from hospitalization to post-PCI） and sequential ther- apy group （n = 47, received atorvastatin 80mg/d after hospitalization, then 40mg on 4h before PCI, 40mg/d after PCI for one month, then 20mg/d for long-term maintenance）. Blood lipid and inflammatory factor levels were com- pared between two groups before, 3d and three months after medication. Results： Compared with before treatment, there were significant reductions in levels of TC, LDL-C, hsCRP, myeloperoxidase （MPO） and matrix metallopro- teinase （MMP） -9 in two groups on 3d and three months after treatment, P〈0.05 or〈0.01 . Compared with rou- tine treatment group, on 3d and three months after treatment, there were significant reductions in levels of TC [3d： （4. 16 ±1.04） mmol/L vs. （3.57 ＋ 0.81） mmol/L, three months： （3.36 ±1.01） mmol/L vs. （3.17 ±0.64） mmol/ L3, LDL-C [3d： （2.23±0.54） mmol/L vs. （1.86±0.57） mmol/L, three months： （1.89±0.58） mmol/L vs. （1.52 ±0.37） mmol/L], hsCRP [3d： （7. 42 ±2.75） mg/L vs. （5.35 ±1.94） mg/L, three months： （2.57 ±0.31） mg/L vs. （1.89 ±0.18） mg/L]and MMP-9 [3d： （859.45 ±221.36） pg/ml vs. （672.59 ±213.62） pg/ml, three months： （675.75 ±141.63） pg/ml vs. （437. 96 ±114. 38） pg/ml] in sequential therapy group, P〈0. 01 all. There were no significant difference in incidence rates of adverse drug reactions and adverse cardiovascular events between two groups, P〉0.05 both. Conclusion： Both routine and sequential atorvastatin therapy can effectively reduce blood lipid and inflammatory factor levels in patients a

关 键 词：血管成形术 气囊 冠状动脉 血脂异常 炎症 阿托伐他汀 

分 类 号：R541.4[医药卫生—心血管疾病]