术前负荷量阿托伐他汀对经皮冠状动脉介入治疗术后心肌损伤的影响研究

目的探讨经皮冠状动脉介入治疗（PCI）术前服用负荷量（80mg）国产阿托伐他汀对PCI术后心肌损伤的影响及其安全性。方法选择可疑冠心病欲行冠状动脉造影的患者,随机分为A、B两组,两组均予以冠心病常规治疗,B组在常规治疗基础上术前6～24h加用阿托伐他汀80mg,冠状动脉造影术后,A组有108例行介入治疗作为对照组,B组114例行介入治疗作为实验组。观察两组患者术后肌酸激酶同工酶MB（CK-MB）和肌钙蛋白I（TNI）升高比例及药物性肝损害和肌病的发生率。结果实验组PCI术后CK-MB超过正常上限、超过正常3倍及TNI阳性的患者比例均低于对照组,差异有统计学意义。两组患者术后均无药物性肝损害及肌病的发生。结论 PCI术前服用80mg阿托伐他汀能减少PCI术后心肌损伤的发生,并且安全性较好。

The Influence of Taking Loading Dose of Atorvastatin before Percutaneous Coronary Intervention on Postoperative Myocardial Damage

Objective To investigate the effects of taking loading dose(80 mg) of atorvastatin before percutaneous coronary intervention(PCI) on postoperative myocardial damage and the issue of safety.Methods The patients,coronary artery disease(CHD) doubtful,intended to take coronary arteriography(CAG) were divided into two groups(A and B) randomly.Both of them were treated with conventional therapy of CHD and PCI,and the patients of group B were taken administration with atorvastatin(80 mg,6-24 hours before operation).There were 108 patients in group A(control group),and 114 patients in group B(experimental group).The rise of postoperative isoenzymes of creatine kinase MB(CK-MB) and troponin I(TNI) were compared between two groups,and the incidence of medicinal hepatitis and myopathy were observed.Results The proportion of patients of postoperative CK-MB over upper limits of normal,or even triple times above normal level,and TNI positive in experimental group were lower than control group,(P<0.05).The medicinal hepatitis or myopathy was not found in two groups after operation.Conclusion Taking atorvastatin(80mg) is safe and may reduce incidence of postoperative myocardial damage.