阿托伐他汀对急性心肌梗死冠脉介入治疗术后的疗效及再狭窄的影响

目的：观察不同剂量阿托伐他汀对急性心肌梗死（acute myocardial infarction,AMI）冠脉介入治疗（percutaneous coronary intervention,PCI）术后的疗效及再狭窄的影响。方法：选择急性心肌梗死PCI术后的患者162例,按不同剂量阿托伐他汀分为A组20mg／d、B组40mg／d,每组调脂治疗共12个月。分别于PCI术前及PCI术后6个月末、12个月末测定血脂水平、血清C反应蛋白（CRP）、IL-6、NO、降钙素基因相关肽（CGRP）、血浆内皮素-1（ET—1）、肱动脉舒张内径变化率（D％）、肝肾功能及心肌酶水平;主要观察阿托伐他汀疗效、不良反应和心脏不良事件。结果：治疗后B组的TC、低密度脂蛋白胆固醇（LDL-C）、CRP、IL-6、ET-1降低,高密度脂蛋白胆固醇（HDL-C）、NO、CGRP、△D％升高与A组PCI术后同期比较,差异有统计学意义（P〈0．05）,并且无严重不良反应。B组降低PCI术后再狭窄的发生率与A组比较,差异也有统计学意义（P〈0．05）。结论：大剂量阿托伐他汀的抗炎作用及改善血管内皮功能明显,能显著降低PCI术后再狭窄的发生率。

Influence of atorvastatin on the curative effect and restenosis in patients with acute myocardial infarction for postoperative percutaneous coronary intervention

To investigate the influence of different dose atorvastatin on the curative effect and restenosis in patients with acute myo-cardial infarction for postoperative percutaneous coronary intervention (PCI). METHODS: 162 patients with acute myocardial infarction for postoperative PCI were divided into Group A (atorvastatin 20 mg/d group) and Group B(ator-vastatin 40 mg/d group), both of which were treated with atorvastatin for 12 months. Serum lipid, CRP, IL-6, NO, CGRP, ET-1, D%, liver function, renal function and CK were measured before PCI, 6 months and 12 months after PCI. In addition,the curative effects of atorvastatin, adverse cardiovascular outcomes and side effect of atorvastatin were observed. RESULTS: Compared with the Group A, the TC, LDL-C, CRP, IL-6, ET-1 were significantly reduced and the HDL-C, NO, CGRP, D% were improved in Group B after treatment (P<0. 05), and therewas no statistical difference(P<0. 05) with no severe side effect. In addition, the morbidity of restenosis after PCI in Group B was decreased, and there was no statistical difference ( P < 0.05). CONCLUSION: High dose atorvastatin have a significantly anti-inflammatory effect and endothelial function improvement, decreasing significantly the morbidity of restenosis after PCI.