不同剂量阿托伐他汀钙片对冠状动脉介入治疗术后急性冠脉综合征患者的影响  

Effects of Different Doses of Atorvastatin Calcium in Patients with Acute Coronary Syndrome after Percutaneous Coronary Intervention

作　　者：杨旭光 徐炳欣 郭树领 陈静静 阮露芳 YANG Xu-guang;XU Bing-xin;GUO Shu-ling;CHEN Jing-jing;RUAN Lu-fang(Department of Cardiovascular Medicine,Xuchang Central Hospital,Xuchang 461000,China;Department of Pharmacy,Xuchang Central Hospital,Xuchang 461000,China;Xuchang Key Laboratory of Cardiovascular Drugs Clinical Research,Xuchang 461000,China)

机构地区：[1]许昌市中心医院心血管内科,许昌461000 [2]许昌市中心医院药学部,许昌461000 [3]许昌市心血管药物临床研究重点实验室,许昌461000

出　　处：《中国合理用药探索》2022年第3期56-61,共6页Chinese Journal of Rational Drug Use

基　　金：2018年中央引导地方科技发展专项资金支持项目{豫财科[2018]106号};许昌市重大科技专项(20180113031)。

摘　　要：目的:探讨不同剂量阿托伐他汀钙片对急性冠脉综合征(ACS)患者经皮冠状动脉介入(PCI)治疗术后炎性反应及主要不良心血管事件(MACE)的影响。方法:前瞻性纳入160例行PCI治疗的ACS患者,采用随机数字表法分为观察组和对照组,每组各80例。在常规治疗方案的基础上,观察组患者PCI术后服用阿托伐他汀钙片40mg,每晚1次;对照组患者PCI术后服用阿托伐他汀钙片20mg,每晚1次。两组均治疗3个月。分析两组患者PCI术前、术后1个月、术后3个月的血清超敏C反应蛋白(hs-CRP)和白介素-6(IL-6)水平的变化,比较两组患者血清低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)及甘油三酯水平,记录MACE及药品不良反应(ADR)发生情况。结果:术前两组血清hs-CRP、IL-6水平无统计学差异(P>0.05);不同剂量阿托伐他汀钙片降低血清hs-CRP、IL-6水平的作用有统计学差异(Fhs-CRP=14.361,P<0.001;FIL-6=18.162,P<0.001);两组血清hs-CRP、IL-6水平随治疗时间而降低(Fhs-CRP=11.462,P<0.001;FIL-6=16.824,P<0.001);术后1、3个月血清hs-CRP、IL-6水平均低于术前,且术后1个月时观察组血清IL-6、hsCRP水平低于对照组(P<0.05);阿托伐他汀钙片的给药剂量与治疗时间有交互作用(Fhs-CRP=3.342,P=0.036;FIL-6=3.681,P=0.027),两组血清hs-CRP、IL-6水平变化趋势有一定差异;两组术后1、3个月血清LDL-C、TC水平均低于术前(P<0.05);观察组术后3个月血清LDL-C、TC水平低于对照组(P<0.05);两组MACE及ADR总发生率无统计学差异(P>0.05)。结论:阿托伐他汀钙片可显著降低ACS患者PCI术后炎性反应、血清LDL-C及TC水平,40mg剂量效果更佳,不同剂量阿托伐他汀对MACE的影响无统计学差异。Objective: To investigate the effects of different doses of atorvastatin calcium on inflammatory reaction and major adverse cardiovascular events(MACE) in patients with acute coronary syndrome(ACS) after percutaneous coronary intervention(PCI). Methods: A total of 160 ACS patients underwent PCI were prospectively enrolled and divided into observation group and control group using random number table, with 80 cases in each group. On the basis of routine treatment, the observation group was given atorvastatin calcium 40 mg once at bed time every day after PCI, while patients in control group were given atorvastatin calcium 20 mg once at bed time every day after PCI. The course of treatment was 3 months in both groups. The changes of serum hypersensitive C reactive protein(hs-CRP) and interleukin-6(IL-6) before PCI, 1 month after PCI and 3 months after PCI were studied. The levels of serum low density lipoprotein cholesterol(LDL-C), high density lipoprotein cholesterol(HDL-C), total cholesterol(TC) and triglyceride were compared between the two groups, and the occurrence of MACE and adverse drug reaction(ADR) were recorded. Results: There was no significant difference in serum hs-CRP and IL-6 levels between the two groups before operation(P>0.05);different doses of atorvastatin calcium had statistical difference in the treatment of reducing serum hs-CRP and IL-6 levels(Fhs-CRP =14.361, P<0.001;FIL-6 =18.162, P<0.001);the levels of serum hs-CRP and IL-6 in the two groups showed a trend of change with the treatment time(Fhs-CRP = 11.462, P<0.001;FIL-6 =16.824, P<0.001). The levels of serum hs-CRP and IL-6 in the observation group were lower than those in the control group at 1 and 3 months after PCI(P<0.05). One month after PCI, the serum IL-6 and hs-CRP level in the observation group was lower than that in the control group. There was interaction between different dosage of atorvastatin and treatment time(Fhs-CRP=3.342, P=0.036;FIL-6 =3.681, P=0.027), and the change trend of serum hs-CRP and IL-6 was different betwee

关 键 词：阿托伐他汀钙片 经皮冠状动脉介入术 急性冠脉综合征 炎性反应 主要不良心血管事件 

分 类 号：R541.1[医药卫生—心血管疾病]