阿托伐他汀对冠脉介入治疗的不稳定型心绞痛患者生物标记物的影响

目的：观察不稳定型心绞痛患者冠脉介入治疗前后生物标记物的变化趋势及不同剂量阿托伐他汀对其的影响,探讨不稳定型心绞痛介入患者合适的他汀剂量。方法：本研究入选188例择期冠脉介入术的不稳定型心绞痛患者,随机分为3组,A组60例,在常规治疗基础上加用阿托伐他汀10 mg·d^-1;B组63例,在常规治疗基础上加用阿托伐他汀20 mg·d^-1;C组65例,在常规治疗基础上加用阿托伐他汀40 mg.d^-1。观察围手术期血脂-总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）及生物标记物-高敏C反应蛋白（hs-CRP）,基质金属蛋白酶-2（MMP-2）。结果：3组患者服用阿托伐他汀6天后检测血脂各组分较治疗前无明显差异;3组患者术前服用阿托伐他汀3天后生物标记物即有下降（P＜0.05）;3组患者PCI术后12小时生物标记物较术前有明显升高（P＜0.01）;3组患者术后3天生物标记物较术后12小时有明显降低（P＜0.01）,且C组患者降低程度更大（P＜0.01）。结论：冠脉介入术可造成血管炎症反应,阿托伐他汀可降低此炎症反应,并不依赖调节血脂作用,剂量为40 mg·d^-1的治疗效果更显著。

Effect of Atorvastatin on Serum Biomarkers of Patients with Unstable Angina Undergoing Percutaneous Coronary Intervention

OBJECTIVE： To observe the change of the biological markers before and after percutaneous coronary intervention in patients with unstable angina and the effect of different doses of atorvastatin on the biological marker,and study the optimal dosage of atorvastatin for patients with unstable angina.METHODS： A total of 188 patients with unstable angina who were expected to undergo percutaneous coronary intervention were randomly assigned into three groups： group A（n=60） received atorvastatin 10 mg·d^-1 plus routine therapy, group B （ n = 63 ） received atorvastatin 20 rag·d^-1 plusroutine therapy, and group C （n = 65） received atorvastatin 40 rag·d^-1 plus routine therapy. During perioperative period, serum levels of TC, TG, LDL - C and HDL - C and biological markers hs - CRP and MMP - 2 were measured. RESULTS ： As eompared with before treatment, no significant differences were noted in all the 3 groups after atorvastatin - treatment of 6 days. There were decreases in serum biomarkers after taking atorvastatin for 3 days before PCI （ P 〈 0.05 ）, but which significantly inereased at 12 hours after PCI in all the three groups （P 〈 0.01 ） and significantly lower at 3 days as compared with at 12 hours after PCI （P 〈 0.01）, much as in group C （P 〈 0.01）. CONCLUSION： Pereutaneous eoronary intervention may induce vascular inflammatory reaction, but which can be attenuated by Atorvastatin without depending on the lipid - regulating effect, especially at a dosage of 40 mg· d^-1