急性冠状动脉综合征介入术前应用他汀类药物强化治疗的疗效观察

目的 探讨急性冠状动脉综合征(ACS)介入术前应用他汀类药物强化降脂对患者血清C反应蛋白(CRP)及血脂水平的影响.方法 将2010年5月～2011年10月收治的确诊为ACS拟行经皮冠状动脉介入(PCI)治疗的150例患者随机分为强化治疗组和常规治疗组各75例.强化治疗组术前7d给予阿托伐他汀80mg口服,每天1次；常规治疗组术前7d给予阿托伐他汀20 mg口服,每天1次；余治疗相同.检测治疗前后两组CRP及血脂水平.结果 治疗前、治疗后1d和7d,强化治疗组CRP水平分别为(8.1±3.1)、(12.6±3.2)、(7.9±2.7 )mg/L,常规治疗组分别为(8.21±3.0)、(13.0±3.3)、(11.8±3.1 )mg/L,两组术后CRP水平均先升高后降低,治疗后1d两组无明显差异(P＞0.05),治疗后7d两组比较有显著差异(P＜0.05).两组治疗前TC、TG、HDL、LDL水平无明显差异,两组治疗后TC、TG、LDL均降低,HDL均升高,组内与组间比较均无显著差异(P＞0.05).结论 急性冠状动脉综合征患者行PCI术前应用高剂量的他汀类药物短期强化预处理不仅可以强化调脂作用,而且可以明显减少PCI术的炎症反应,从而减少术后心血管事件的发生.

Effect of high dose statin pretreatment for percutaneous coronary intervention patients with acute coronary syndrome

【Objective】 To investigate the influence of high dose statin pretreatment on serum C-reactive protein(CRP) and lipid levels for percutaneous coronary intervention(PCI) patients with acute coronary syndrome(ACS).【Methods】 150 patients with ACS who were admitted to suffering from PCI from May 2010 to October 2011 were randomly divided into intensive therapy group and the conventional therapy group with 75 cases in each group.Patients in the intensive therapy group were given atorvastatin 80 mg orally,qd;but patients in the conventional therapy group received atorvastatin 20 mg orally,qd.A 7-day pretreatment with atorvastatin was given to the subjects.The two groups were identical in other medication treatment.CRP and lipid levels were measured at baseline,1 and 7 day after the procedure.【Results】 At baseline,1 and 7 day after PCI,CRP levels were respectively(8.1±3.1),(12.6±3.2),(7.9±2.7) mg/L in the intensive therapy group,and(8.21±3.0),(13.0±3.3),(11.8 ± 3.1) mg/L in the conventional therapy group.Postoperative CRP levels were first increased and then decreased,with no significant difference at 1 day after treatment(P >0.05) and significant differences at 7 day after treatment(P <0.05).Before treatment,TC,TG,HDL and LDL levels were not significantly different.After treatment,TC,TG and LDL levels were decreased,but HDL were increased,and the intensive therapy group compared with the conventional treatment group were significantly different(P <0.05).【Conclusion】 High-dose short-term intensive statin pretreatment for acute coronary syndrome underwent PCI can not only strengthen decreasing the lipid,but also can significantly reduce inflammation of PCI,thereby reducing the incidence of postoperative cardiovascular events.