不同剂量阿托伐他汀在经皮冠状动脉介入治疗中的作用研究

目的探讨经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗前给予不同剂量阿托伐他汀对心肌损伤及术后主要不良心血管事件(major adverse cardiac events,MACE)的影响。方法 172例拟行PCI的不稳定性心绞痛(un-stable angina pectoris,UAP)患者按照入院时间及造影结果分为治疗组和对照组各86例。两组患者术前、术中及术后均给予UAP常规治疗。在PCI前,治疗组与对照组分别接受7天的阿托伐他汀钙(40 mg/d)、阿托他汀钙(20 mg/d)治疗。在术前及术后24小时监测肌钙蛋白I(cTnI),并随访术后3个月内的主要不良心血管事件。结果术后24小时,治疗组cTnI显著降低(P<0.01),对照组cTnI显著升高(P<0.01);两组间比较,差异有统计学意义(P<0.01)。术后3个月内治疗组有3例发生不良心血管事件,对照组有13例患者发生不良心血管事件,两组间比较差异有统计学意义(P=0.033)。结论 PCI前给予阿托伐他汀40 mg/d预防性7天治疗,可以减少PCI造成的心肌损伤,减少术后3个月的主要不良心血管事件。

The effect of different dosages of Atorvastatin on percutaneous coronary intervention

Objective To explore the effects of different dosages of Atorvastatin on the myocardial injury and major adverse cardiac events （MACE） after percutaneous coronary intervention （PCI）. Methods One hundred and seventy two patients with unstable angina pectoris（UAP） who were scheduled for PCI were divided into treatment or control groups according to date of admission and the results of radiography,86 in each. In treatment group patients were treated with atorvastatin 40 mg daily while in control group patients received atorvastatin 20 mg daily. After 7 days treatment, PCI were performed. Serum cardiac troponin I （cTnI）was measured in 24 h be- fore and after surgery and MACE after PCI were recorded after 3 months of surgery as well. Results After 24 h of surgery, serum cTnl was significantly decreased in the treatment group but dramatically decreased in the control group compared to pre-operation. The cTnl of preoperative and postoperative in the treatment group was significantly lower than that in control group. The MACE in 3 months after PCI in treatment group was less than that in control group. Conclusions The administration of 40 mg per day of atorvastatin for 7 days before PCI could significantly reduce myocardial injury, and decreased the occurrence of MACE in 3 months post-PCI.