摘要
目的 观察急性冠脉综合征（ACS）患者经皮冠状动脉介入治疗（PCI）前给予阿托伐他汀强化治疗,术后血样高敏C-反应蛋白（hs-CRP）、肿瘤坏死因子（TNF）-α、P-选择素水平的变化,探讨其临床意义.方法 选择择期行PCI的住院患者78例,按随机数字表法分为两组：标准治疗组39例（阿托伐他汀20mg/d）,强化治疗组39例（于术前12、2 h分别给予阿托伐他汀40、20mg）.检测两组患者术前1 d,术后6、12 h hs-CRP、TNF-α、P-选择素水平,并进行比较.结果 标准治疗组28例、强化治疗组29例成功置入支架.两组术前1 d hs-CRP、TNF-α、P-选择素水平比较差异无统计学意义（P＞0.05）,术后6、12 h均较术前显著升高（P＜0.05）,标准治疗组术后12 h较术后6 h仍明显增高[hs-CRP：（10.29±0.77）mg/L比（6.34±1.23）mg/L;TNF-α：（58.15±5.19）ng/L比（36.12±3.89）ng/L;P-选择素：（49.58±4.92）μg/L比（31.47±3.71）μg/L]（P＜0.05）,强化治疗组术后12 h与术后6 h相比虽仍有升高,但差异无统计学意义[hs-CRP：（6.83±1.46）mg/L比（5.95±1.17）mg/L;TNF-α：（42.18±7.79）ng/L比（34.07±8.79）ng/L;P-选择素：（33.57±4.63）μg/I比（29.78±5.61）μg/L]（P＞0.05）.标准治疗组术后6、12 h hs-CRP、TNF-α、P-选择素水平较强化治疗组增高,但差异无统计学意义（P＞0.05）.结论 ACS患者PCI前短期给予阿托伐他汀强化治疗,可有效降低患者hs-CRP、TNF-α、P-选择素水平,有助于PCI后机体促炎和抗炎失衡状态的恢复.
Objective To observe the changes of postoperative blood high sensitive C-reactive protein （hs-CRP）, tumor necrosis factor（TNF）-o, P-selectin levels in patients with acute coronary syndrome （ACS） who had an atorvastatin intensive treatment before operation, and investigate its clinical significance.Methods Seventy-eight cases of ACS patients who intended to undergo percutaneous coronary intervention were divided into two groups by random digits table：39 patients comprising the standard treatment group （given atorvaatatin 20 mg/d, conventional treatment）, 39 patients comprising the enhanced group （given atorvastatin 40 mg, 20 mg separately at preoperative 12 h, 2 h on the basis of conventional treatment）.Among them, 28 cases of the standard treatment group and 29 cases of the enhanced group finally underwent the test. The hs-CRP,TNF-α ,P-selectin levels at preoperative 1 day,postoperative 6 h,postoperative 12 h were detected and then the changes of three factors were analyzed. Results There was no significant difference in hs-CRP,TNF- α, P-selectin between the two groups at preoperative 1 day. The values of the two groups markedly increased at postoperative 6 h, 12 h and the difference was statistically significant （P 〈0.05）. The values of the standard treatment group were markedly higher at postoperative 12 h than those at postoperative 6 h,and the difference was statistically significant [hs-CRP： （10.29 ± 0.77） mg/L vs. （6.34 ±1.23） mg/L;TNF-α： （58.15±5.19） ng/L vs. （36.12 ± 3.89） ng/L;P-selectin： （49.58 ±4.92） μg/L vs.（31.47 ± 3.71） μ g/L] （P 〈 0.05）. However, the values of the enhanced group were higher at postoperative 12 h than those at postoperative 6 h but the difference was no statistically significant [hs-CRP： （6.83 ± 1.46）mg/L vs. （5.95 ± 1.17） mg/L; TNF- o： （42.18 ± 7.79） ng/L vs. （34.07 ± 8.79） ng/L; P-selectin： （33.57 ±4.63） μ g/L vs. （29.78 ± 5.61） μ g/L] （P 〉 0.05）. Three factors in standard treatment group were elevating significantly at postoperative 6 h, 12 h compared with those in the enhanced group, but the difference was no statistically significant （P 〉 0.05）. Conclusion Short-term intensive therapy of atorvastatin in ACS patients who intend to do PCI, can reduce the hs-CRP, TNF-α, P-selectin levels effectively.
出处
《中国医师进修杂志》
2011年第10期16-19,共4页
Chinese Journal of Postgraduates of Medicine
