术前强化他汀治疗对冠心病病人PCI术后心肌标志物及炎性指标的影响

目的:探讨PCI术前进行他汀治疗对冠心病病人心肌标志物及炎性指标的影响.方法:选择择期行PCI冠心病病人150例作为研究对象,随机分为A、B、C 3组,各50例.PCI术前分别对A、B、C组使用剂量20、40和60 mg的阿托伐他汀钙,观察术后3组病人心肌标志物肌酸激酶同工酶、肌钙蛋白和炎症标志物高敏C反应蛋白、一氧化碳和血内皮素水平的变化及术后30 d内的主要不良心脏病事件.结果:3组病人PCI术后心肌标志物肌酸激酶同工酶、肌钙蛋白水平均较手术前明显上升(P<0.01~P<0.05),且C组病人心肌标志物水平较A、B组病人更接近正常水平(P<0.05);PCI术后3组病人高敏C反应蛋白、血内皮素水平均较术前显著下降(P<0.01),且C组较A、B组下降更明显(P<0.05~P<0.01),3组病人一氧化碳水平均显著上升(P<0.01),且C组较A、B组上升更明显(P<0.05~P<0.01);PCI术后C组病人主要心脏不良事件发生率为2.2%,明显低于其他2组的22.0%和10.0%(P<0.01).结论:冠心病病人择期PCI术前应用60 mg/d阿托伐他汀能够显著降低心肌损伤及炎症反应,术后不良心脏事件少,安全性好,值得推广应用.

Effect of the intensive treatment with atorvastatin calcium before operation on the myocardial markers and inflammatory factors in patients with coronary heart disease after percutaneous coronary intervention

Objective:To explore the effects of the treatment with atorvastatin calcium before operation on the myocardial markers and inflammatory factors in patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods:One hundred and fifty coronary heart disease patients scheduled by PCI were randomly divided into group A,B and C(50 cases each group).Group A,B and C were treated with 20,40 and 60 mg of atorvastatin calcium before PCI,respectively.The levels of CTnI,CK-MB,hs-CRP,NO and ET in 3 groups were detected after 3 days of operation,and the adverse heart events within the postoperative 30 days were observed.Results:Compared with before operation,the levels of CTnI and CK-MB in 3 groups significantly increased 3 days after PCI(P<0.05 to P<0.0),and the levels of myocardial markers in group A and group B closely arrived at the normal levels compared with group C(P<0.05).Compared with before operation,the levels of hs-CRP and ET in 3 groups significantly decreased 3 days after PCI(P<0.01),and the decreasing degree of which in group C was more obvious compared with group A and group B(P<0.05 to P<0.01).Compared with before operation,the levels of NO in 3 groups significantly increased 3 days after PCI(P<0.01),and the increasing degree of which in group C was more obvious compared with group A and group B(P<0.05 to P<0.01).The incidence rate of adverse heart event in group C(2.2%) was significantly lower than that in group A(22.0%) and group B(10.0%) (P<0.01).Conclusions:The application of 60 mg/d of atorvastatin calcium in coronary heart disease patients scheduled by PCI can significantly reduce the myocardial injury,inflammation reaction and postoperative adverse heart events,and which is safe and worthy of promotion and application.