瑞舒伐他汀联合曲美他嗪治疗对经皮冠状动脉介入相关心肌损伤的影响

目的：探讨瑞舒伐他汀联合曲美他嗪治疗对PCI相关心肌损伤的影响。方法收集需行PCI术的120例稳定型心绞痛患者，随机分为瑞舒伐他汀联合曲美他嗪治疗组（试验组）和单用瑞舒伐他汀治疗组（对照组），每组各60例。对照组按稳定型心绞痛治疗指南行常规治疗，并在PCI术前5 d予瑞舒伐他汀10 mg/d，试验组在对照组基础上加予曲美他嗪20 mg，每日3次，术前至少使用5 d，术后长期使用。分别在PCI术前、术后12 h、术后3 d检测两组患者的血清人可溶性CD40配体（sCD40L）及超敏肌钙蛋白T （hsTnT）水平。随访半年，比较两组患者主要心血管事件发生率的差异。结果两组术前冠状动脉病变情况及PCI术中植入支架枚数比较差异均无统计学意义（P＞0.05）。术前两组稳定型心绞痛患者sCD40L、hsTnT水平比较差异亦无统计学意义（P＞0.05）。术后12 h两组患者sCD40L、hsTnT水平均比术前明显升高（P均＜0.01），其中对照组sCD40L、hsTnT水平均明显高于试验组（P均＜0.01）。术后3 d 两组患者 sCD40L、hsTnT水平均明显下降（P均＜0.01），其中试验组sCD40L、hsTnT水平均明显低于对照组（P均＜0.01）。术后随访半年，试验组再发心绞痛病例明显少于对照组（P＜0.05）。结论 PCI术前联合使用曲美他嗪及瑞舒伐他汀治疗对降低PCI术后血清sCD40L、hsTnT水平疗效优于单用瑞舒伐他汀，有利于减少PCI相关心肌损伤，长期使用可降低心肌缺血事件的发生率。

Influence of rosuvastatin combined with trimetazidine on percutaneous coronary intervention- related myocardial injury

Objective To evaluate the influence of rosuvastatin combined with trimetazidine on per-cutaneous coronary intervention （PCI）related myocardial injury. Methods One hundred and twenty patients with stable angina undergoing PCI were recruited. And they were divided into rosuvastatin combined with trime-tazidine group （experiment group,n=60）and rosuvastatin group （control group,n=60）. Patients in control group were treated according to stable angina guideline,and received rosuvastatin （10mg qd）for at least 5 days before PCI. On the basis of control group,patients in experiment group also received trimetazidine （20mg tid）for at least 5 days before PCI,and then kept as long-term use after operation. Levels of serum sCD40L and hsTnT were measured before PCI,12 hours and 3 days after PCI,respectively. Differences of major cardiovas-cular events were obsvered and compared in two groups for 6 months follow-up. Results There was no signifi-cant difference between two groups with respect to the clinical baseline data,coronary lesions,number of im-planted stent,levels of serum sCD40L and hsTnT （P〉0.05）. Levels of sCD40L and hsTnT at 12 hours after PCI were significantly higher than those before PCI （P〈0.01）,but levels in control group were higher than those in experiment group （P〈0.01）. 3 days after PCI,levels of Serum sCD40L and hsTnT were significantly decreased in two groups,but levels in experiment group were lower than those in control group （P〈0.01 ）.During 6 months follow-up,the incidence of recurrent angina in patients of experiment group was significantly＆amp;nbsp;reduced than that of control group （P〈0.05 ）. Conclusion Combination of trimetazidine and rosuvastatin therapy before PCI can reduce levels of serum sCD40L and hsTnT,and help to reduce coronary intervention-re-lated myocardial injury. The incidence of myocardial ischemic events will be reduced with long-term use.