他汀强化预处理对PCI介导CEMPAS的防治效果观察  

Statin pretreatment and intensive therapy for distal coronary embolization and abnormal myocardial perfusion related to percutaneous coronary interventions(CEMPAS)

作　　者：孙伏清[1] 林永芳 周密[1] 郭城 黄奇 林凯金 陈平[1] SUN Fuqing;LIN Yongfang;ZHOU Mi;GUO Cheng;HUANG Qi;LIN Kaijin;CHEN Ping(Department of Cardiovascular,Fuqing Municipal Hospital,Fuqing Municipal Hospital Affiliated to Fujian Medical University,Fuqing,Fujian350300,China)

机构地区：[1]福建医科大学附属福清市医院福建省福清市医院心血管内科,福清350300

出　　处：《福建医药杂志》2021年第2期27-30,共4页Fujian Medical Journal

摘　　要：目的探讨他汀类药物强化预处理对经皮冠状动脉介入治疗(PCI)介导的相关性远端血管栓塞及心肌灌注障碍(CEMPAS)的防治效果。方法选择212例具备PCI术指征的急性冠脉综合征(ACS)患者,男156例,女66例;年龄(65±11)岁。随机分为两组:110例术前7d服用阿托伐他汀40mg/d强化治疗,其余102例服用阿托伐他汀20mg/d常规剂量治疗。分别测量PCI术前及PCI术后心肌梗死溶栓治疗(TIMI)血流水平及术后6h肌钙蛋白I (TnI)、肌酸激酶同工酶(CK-MB)、高敏C反应蛋白(hs-CRP),并评估两组患者临床随访3个月的主要心血管事件。结果两组患者的基线水平及血管造影的特征具有可比性。PCI术前两组患者的TnI、CK-MB和hs-CRP水平无差异;PCI术后TnI、CK-MB和hs-CRP水平均增加。他汀强化治疗组患者与常规剂量他汀治疗组比较,PCI术后即刻3级血流发生率[(99.5±5.2)%vs (96.7±5.0)%,P<0.05]较高,术后6hTnI、CK-MB、hs-CRP水平[(0.36±0.12)vs (1.33±0.47)ng/mL,P<0.01;(14.2±5.78)vs (47.3±16.4)IU/L,P<0.05;(6.42±3.56)vs (8.23±3.67)mg/L,P<0.05]及随访3个月的主要心血管事件发生率(0.9%vs 2.9%,P<0.05;0.9%vs 3.9%,P<0.05;0.9%vs 2.9%,P<0.05)均明显降低。结论该研究表明ACS患者实施阿托伐他汀强化预处理具有改善PCI介导的CEMPAS的防治效果。Objective This study sought to investigate potential protective effects of atorvastatin in patients with CEMPAS undergoing percutaneous coronary intervention(PCI).Methods A total of 212 ACS patients[156 males and 66 females,aged(65±11)years]with PCI indications were randomly divided into two groups:110 cases were taken seven days before PCI with atorvastatin 40 mg/day intensive treatment,and the remaining 102 patients were treated with regular doses of atorvastatin20 mg/day.The thrombolysis in myocardial infarction(TIMI)blood flow levels before and after PCI,and TnI,CK-MB,and hs-CRP six hours after operation weremeasured,and the major cardiovascular events within three months of clinical follow-up in both groups were assessed.Results Baseline clinical and angiographic characteristics of the two groups of patients were comparable.There were no differences in TnI,CK-MB and hs-CRP levels between the two groups of patients before PCI.TnI,CKMB and hs-CRP levels increased after PCI.Patients in the statin intensive treatment group had slow blood flow or no regurgitation immediately after PCI.The levels of TnI,CK-MB,and hs-CRP at six hours after surgery were followed.Compared with maintaining regular doses of statin group,the major cardiovascular events during the 3-month follow-up period were significantly reduced.Conclusion The study shows that intensive atorvastatin pretreatment in patients with ACS can improve the prevention and treatment of PCI-mediated CEMPAS.

关 键 词：他汀 急性冠脉综合征 经皮冠脉介入手术 

分 类 号：R543.3[医药卫生—心血管疾病] R540.46[医药卫生—内科学]