围手术期阿托伐他汀治疗对冠状动脉旁路移植术后心房颤动的控制

目的探讨围手术期口服阿托伐他汀降脂药对冠状动脉旁路移植（coronary artery bypass grafting,CABG）术后患者心房颤动（atrial fibrillation,AF）的控制。方法298例行CABG术连续患者,根据围手术期是否予以阿托伐他汀药物分为他汀组及对照组各149例,分析比较两组术后心房颤动发生情况及超敏C反应蛋白（hs-CRP）、血脂水平变化。结果用统计学软件SPSS13.0处理,计数资料应用χ2检验或校正χ2,计量资料应用t检验,P值〈0.05认为差异有统计学意义。结果他汀组和对照组在病史特点、手术操作及围手术期参数方面无统计学差异。术后房颤65例,总发生率21.8%,他汀组（14.8%）和对照组（28.9%）差异有显著统计学意义（χ2=8.677,P=0.003）。两组相比,他汀组症状性房颤发生率及房颤持续时间较对照组减少,差异有统计学意义（χ2=5.471,P=0.019;t=4.142,P=0.014）。Hs-CRP在两组中变化相似,术后3d水平最高,术后1周逐渐降低,术后3个月均能控制在正常低水平。对照组术后3d及1周较术前相比均有显著升高,差异具有统计学意义（t=1.746和2.818,P〈0.05）。同期比较,他汀组术后3d及1周hs-CRP显著低于对照组（t=16.344和6.029,P〈0.05）。他汀组和对照组血总胆固醇浓度在术后1周及3个月较术前比较均有显著降低（t=1.675和1.376,P〈0.05;t=1.413和1.472,P〈0.05）。结论围手术期口服阿托伐他汀除对CABG术后患者的血脂有效调节外,对全身炎症反应有明显减轻,并可降低术后房颤的发生率并缩短持续时间,且无肝肾功能损伤等并发症。

Effectiveness of perioperative atorvastatin therapy on atrial fibrillation after coronary artery bypass grafting surgery

Objective To investigate the effect of perioperative atorvastatin therapy on atrial fibrillation(AF) after coronary artery bypass grafting(CABG) surgery.Methods Two hundred and ninety eight consecutive patients were randomly divided into the statin and the control group with 194 patients in each group respectively.The statin group received perioperative atorvastatin therapy 40mg/d starting 7 days before surgery,whereas the control group received no statin.Compare the incidence of postoperative atrial fibril...