不同剂量阿托伐他汀在CHD伴SAS患者PCI术后中的应用及安全性分析  

Application and safety of different doses of atorvastatin in treatment of CHD complicated by SAS after PCI operation

作　　者：孙丽 张东素 徐佳佳[1] 苏晔[1] SUN Li;ZHANG Dongsu;XU Jiajia(Beijing Chaoyang Hospital Affiliated to Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院,北京市100020

出　　处：《河北医药》2021年第7期1062-1065,共4页Hebei Medical Journal

摘　　要：目的探讨不同剂量阿托伐他汀在冠心病(CHD)伴睡眠呼吸暂停综合征(SAS)患者经皮冠状动脉介入(PCI)术后的应用及安全性。方法选取2016年1月至2018年6月收治的130例CHD伴SAS患者作为研究对象,采用随机数表法分为高剂量组和低剂量组,每组65例。2组均行PCI治疗,并于围术期予以不同剂量的阿托伐他汀。治疗前、治疗1个月后评估两组心功能[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、肺动脉收缩压(PASP)]、SAS相关指标[最低血氧饱和度(LSpO_(2))、平均血氧饱和度(MSaO_(2))、氧减总时间(ODTT)]、炎性因子[C-反应蛋白(CRP)、白介素(IL-6)、可溶性细胞间黏附分子-1(sICAM-1)]、血脂代谢指标[低密度脂蛋白(LDL-C)、三酰甘油(TG)、总胆固醇(TC)],随访6个月记录患者心血管事件发生率。结果治疗1月后,2组LVEF、LVEDD、PASP均低于治疗前(P<0.05),高剂量组LVEF、PASP降幅均大于低剂量组(P<0.05),2组LVEDD比较差异无统计学意义(P>0.05);治疗1月后,2组LSpO_(2)、MSaO_(2)、ODTT均高于术前(P<0.05),高剂量组降幅小于低剂量组(P<0.05);治疗1月后,2组CRP、IL-6、sICAM-1均低于治疗前(P<0.05),高剂量组降幅大于低剂量组(P<0.05);治疗1个月后,2组LDL-C、TG、TC均低于治疗前(P<0.05),高剂量组降幅均大于低剂量组(P<0.05);高剂量组心血管事件发生率低于低剂量组(P<0.05)。结论CHD伴SAS患者PCI术后应用高剂量阿托伐他汀能减少术后心血管事件发生,获益更多。Objective To investigate the application and safety of different doses of atorvastatin in treatment of coronary heart disease(CHD)and sleep apnea syndrome(SAS)CHD complicated by SAS after percutaneous coronary intervention(PCI).Methods A total of 130 patients with CHD complicated by SAS who were admitted and treated in our hospital from January 2016 to June 2018 were enrolled in the study,who were divided into high-dose group and low-dose group according to random number table,with 65 cases in each group.The patients in both groups were treated by PCI and different doses of atorvastatin at perioperative period.The cardiac function indexes including left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),pulmonary arterial systolic pressure(PASP),and SAS related indexes including lowest oxygen saturation(LSpO_(2)),mean oxygen saturation(MSaO_(2)),oxygen desaturation total time(ODTT),and inflammatory factors[C-reactive protein(CRP),interleukin(IL-6),soluble intercellular adhesion molecule-1(sICAM-1)]and lipid metabolism indexes[low-density lipoprotein cholesterol(LDL-C),triglyceride(TG),total cholesterol(TC)]in both groups were detected before treatment and at 1 month after treatment,and the incidence rate of cardiovascular events after 6-month follow up was observed and compared between the two groups.Results After 1-month treatment,the levels of LVEF,LVEDD and PASP in both groups were significantly lower than those before treatment(P<0.05),and the decrease degree of LVEF and PASP in high-dose group were significantly higher than those in low-dose group(P<0.05),however,there was no significant difference in LVEDD between the two groups(P>0.05).After 1-month treatment,the levels of LSpO_(2),MSaO_(2) and ODTT in both groups were significantly higher than those before operation(P<0.05),and the decrease degree in high-dose group was significantly maller than that in low-dose group(P<0.05).After 1-month treatment,the levels of CRP,IL-6,sICAM-1 and LDL-C,TG as well as TC in both groups we

关 键 词：冠心病 睡眠呼吸暂停综合征 经皮冠状动脉介入术 阿托伐他汀 剂量 

分 类 号：R541.4[医药卫生—心血管疾病]