摘要
[目的]研究高海拔地区不稳定型心绞痛（UAP）患者经皮冠脉介入（PCI）术前强化阿托伐他汀治疗的疗效及安全性。[方法]将93例UAP患者随机分成三组，对照组31例（阿托伐他汀20mg／d常规治疗），强化1组31例（常规治疗基础上于术前12h、2h分别予阿托伐他汀40mg、20mg），强化2组31例（常规治疗基础上于术前12h、2h分别给阿托伐他汀80mg、40mg）。观察术前和术后6h，24h患者血浆肌酸磷酸激酶同工酶（CK—MB）、血浆肌钙蛋白（TNT）及炎症反应标志物C反应蛋白（CRP）的变化。1个月后随访强化剂量对患者主要心脏不良事件（预后）及安全性指标的影响。[结果]强化组较对照组心脏不良事件的发生率低（P〈0．05），PCI术后三组CK—MB、TNT及CRP均有不同程度升高，但强化组增高幅度明显低于对照组（P〈0．01）。[结论]高海拔地区uAP患者PCI术前应用阿托伐他汀强化治疗疗效显著，术前12h及2h口服强化剂量阿托伐他汀能明显减少手术对患者造成的心肌损伤及炎症反应，无严重不良反应。
[Objective] To explore the efficacy and safety of pre-percutaneous coronary intervention（PCI） intensive atorvastatin for the treatment of unstable angina pe＇ctoris（UAP） in high-altitude area. [Methods] Totally 93 UAP patients were randomly divided into 3 groups. Control group（n= 31） received routine treatment with atorvastatin 20mg/d. Intensive group 1（n=31） was given atorvastatin 40mg/d and 20mg/d at 12h and 2h before PCI based on routine treatment. Intensive group 2 （n= 31） was given atorvastatin 80mg/d and 40mg/d at 12h and 2h before PCI based on routine treatment. Plasma levels of creatine phosphokinase isoenzyme（CK-MB）, cardiac troponin（TNT） and inflammatory response markers C-reactive protein（CRP） be- fore and 6h and 24h after PCI were observed. The effect of intensive dosage on major adverse cardiac events （prognosis） were followed up after a month. [Results]The incidence of cardiac adverse events in intensive group was lower than that in control group（P%0.05）. After PCI, the levels of CK-MB, TNT and CRP in 3 groups increased in varying degrees, but the increasing of intensive group was obviously lower than that in control group（ P 〈0.01）. [Conclusion] Pre-PCI atorvastatin for the treatment of UAP patients in high-altitude area has significant efficacy. Oral intensive atorvastatin at 12h and 2h before PCI can obviously reduce myocardial damage and inflammatory reaction caused by the operation, and has no serious side reaction.
出处
《医学临床研究》
CAS
2012年第12期2275-2277,共3页
Journal of Clinical Research
