高龄冠心病患者PCI围术期负荷剂量阿托伐他汀的疗效及安全性分析

目的探讨高龄冠心病患者经皮冠状动脉介入治疗(PCI)围术期阿托伐他汀负荷剂量治疗的疗效及安全性。方法选择住院接受PCI治疗的高龄冠心病患者80例,随机分为负荷剂量组和常规剂量组,比较两组PCI术前、术后24hCKMB、cTnI、CRP的水平及PCI术前、术后1个月LDL、TC的水平并随访观察两组患者1个月期间药物主要不良反应及心血管事件的发生情况。结果 (1)常规剂量组PCI术后CKMB、cTnI、CRP水平均较术前升高,差异均有统计学意义(P<0.05),常规剂量组PCI术后24h的CKMB、cTnI、CRP水平均高于负荷剂量组,差异均有统计学意义(P<0.05)。(2)两组在用药后1个月LDL和TC均显著下降,差异有统计学意义(P<0.05),负荷剂量组下降幅度更加显著(P<0.05)。(3)负荷剂量组1个月内心血管事件发生率显著低于常规剂量组,差异有统计学意义(P<0.05)。(4)肝转氨酶升高负荷剂量组3例,常规剂量组2例,两组比较差异无统计学意义(P>0.05)。两组均无肌痛、骨骼肌溶解及肾功能受损等不良反应。结论高龄冠心病患者PCI围术期负荷剂量阿托伐他汀治疗能有效减轻心肌损伤,降低术后心血管事件发生率,且相对安全。

Efficacy and Safety of Intensive Atorvastatin Treatment in old Coronary Artery Disease Patients with PCI Perioperative

Objective To study the efficacy and safety of intensive atorvastatin in old coronary, artery disease patients with percutaneous coronary intervention（PCI） during the periopemtive period. Methods A total of 80 old patients with eoronmy artery disease were randomly divided into conventional dose and intensive dose groups. The CKMB, cTnI, CRP, LDL and TC were compared between two groups. In addition, the adverse drug reaction and major cardiovascular event at follow-up of one month were observed. Results （ 1 ） The CKMB, CTnI and CRP of conventional dose group increased more significantly than that in intensive dose group 24h after PCI（ P 〈 0.05）. （2）After treatment, the LDL and TC of two groups at 30d after atorvastatin treatment were significantly lower than that before treatment （P 〈 0.05）, and decreased more significantly in intensive dose group than conventional dose group（ P 〈 0.05）. （3） Compared with conventional dose group, the major cardiovascular events in intensive dose group were significantly lower （P 〈 0.05）. （4） During the therapy, transaminase elevation were detected 3 cases in intensive dose group and 2 cases in conven- tional dose group. There was no occurance of complications such as myalgia, rhabdomyolysis, and renal function damage etc in all patients. The incidence of adverse di＇ug reaction has no statistical difference between the two groups（ P 〉 0.05）. Conclusions Inten- sive atorvastatin treatment in old patints with coronary artery disease during the perioperative period can reduce pcrioperative myocardial injury after PCI, it can also reduce preoperative major cardiovascular events and with similar safety.