阿托伐他汀预处理对PCI治疗的ACS患者血脂及cTnI、CKMB水平的影响  

Effect of atorvastatin pretreatment on serum lipids and cTnI,CK-MB levels in patients with ACS treated with PCI

作　　者：苏冠丽[1] 孔丹丹 王乐[3] 尹亚娟 刘刚[3] SU Guanli;KONG Dandan;WANG Le;YIN Yajuan;LIU Gang(Seventh Clinical Department of Mental Health Center,The First Hospital of Hebei Medical University,Shijiazhuang He-bei 050031,China;Department of General Medicine,Wenan County Hospital,Langfang Hebei 065800,China;Depart-ment of Heart Center,The First Hospital of Hebei Medical University,Shijiazhuang Hebei 050031,China)

机构地区：[1]河北医科大学第一医院精神卫生中心临床七科,河北石家庄050031 [2]河北省文安县医院普内科,河北廊坊065800 [3]河北医科大学第一医院心脏中心,河北石家庄050031

出　　处：《新疆医科大学学报》2021年第1期65-69,共5页Journal of Xinjiang Medical University

基　　金：河北省科技计划项目(18272495D);河北省卫生健康委员会项目(20190429);河北省科技厅项目(2020TXJC06)。

摘　　要：目的探讨阿托伐他汀预处理对经皮冠状动脉介入治疗(PCI)患者血清脂质及心肌肌钙蛋白I(cTnI)和肌酸激酶同工酶(CK-MB)水平的影响。方法选取河北医科大学第一医院2016年6月-2018年6月收治的符合纳入标准的90例急性冠脉综合征患者,采用随机数字表法分为观察组(n=45)及对照组(n=45)。两组患者术前均常规给予口服阿司匹林100 mg、氯吡格雷300 mg及静脉输注普通肝素(80 IU/kg)等药物治疗。观察组术前给予阿托伐他汀40 mg(立普妥20 mg/片,辉瑞)口服,对照组术前给予安慰剂100 mg(维生素C片剂)口服。两组术后口服阿托伐他汀(20 mg/d),疗程3个月。患者出院后随访1年。结果两组术前血清总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白(LDL-C)水平差异无统计学意义(P<0.05)。两组患者术后7 d血脂水平较术前及术后第1天明显下降(P<0.05),且观察组显著低于对照组(P<0.05)。两组患者术前超敏C反应蛋白(hs-CRP)水平差异无统计学意义(P=0.898),两组患者术后1 d hs-CRP水平较术前均显著增高,但组间差异无统计学意义(P=0.135),术后7 d hs-CRP水平明显低于术后1 d(P=0.000),观察组明显低于对照组(P=0.000)。两组术前cTnI和CK-MB水平差异无统计学意义(P<0.05),术后1 d cTnI和CK-MB水平明显高于术前(P=0.000),但两组间差异无统计学意义(P<0.05),术后7 d cTnI和CK-MB水平较术后1 d显著下降(P=0.000),且观察组显著低于对照组(P=0.000)。观察组总不良心血管事件发生率低于对照组,差异有统计学意义(P=0.01)。结论阿托伐他汀预处理可有效降低患者的血脂和cTnI、CK-MB水平,降低不良心血管事件发生率。Objective:To investigate the effects of atorvastatin pretreatment on serum lipids and cardiac troponin I(cT⁃nI)and creatine kinase-MB(CK-MB)levels in patients with acute coronary syndrome(ACS)treated with percutaneous coronary intervention(PCI).Methods:90 patients with ACS who met our inclusion criteria from June 2016 to June 2018 were enrolled by the first hospital of Hebei medical university.They were divided into observation group(n=45)and control group(n=45)by the random number table.There was no significant difference in clinical data between the two groups(P>0.05).Two groups of patients were routinely given oral aspirin 100 mg,clopidogrel 300 mg and intrave⁃nous infusion of unfractionated heparin(80 IU/kg).The observation group was given atorvastatin 40 mg(Lipitor 20 mg/tablet,Pfizer)orally before the operation,and the control group was given a placebo 100 mg(vitamin C tablet)orally be⁃fore surgery.Both groups received oral atorvastatin(20 mg/d)for 3 months and were followed up for 1 year after dis⁃charge.Results:There were no significant differences in preoperative serum total cholesterol(TC),triglyceride(TG)and low density lipoprotein(LDL-C)between the two groups(P>0.05).The blood lipids of the two groups at the 7th day after the operation were significantly lower than those before and after the operation(P<0.05),and which in the obser⁃vation group was significantly lower(P<0.05).Before the operation,there was no significant difference in C-reactive protein(hs-CRP)between the two groups(P=0.898).1 day after the operation,the levels of high sensitivity hs-CRP in the two group were significantly higher than that before the operation,but there was no significant difference between the two groups(P=0.135).There was a significant decrease(P=0.000)of hs-CRP on the 7th day after operation(P=0.000),and hs-CRP in the observation group was significantly lower than that in the control group(P=0.000).There were no significant differences in preoperative cTnI and CK-MB between the two groups(P>0.05).The leve

关 键 词：阿托伐他汀 急性冠状动脉综合征 经皮冠状动脉介入 

分 类 号：R541.4[医药卫生—心血管疾病]