摘要
目的探讨早期强化瑞舒伐他汀治疗对急性冠状动脉综合征(ACS)患者经皮冠状动脉介入术(PCI)术后心肾功能的影响。方法 ACS患者100例,随机分为早期瑞舒伐他汀标准剂量组(标准组)和强化治疗组(强化组),每组50例,两组均按常规方法行PCI,并于术前7 d开始服用瑞舒伐他汀,标准组服用10 mg/d,强化组20 mg/d。观察两组患者手术前后心肌梗死溶栓(TIMI)血流、TIMI心肌灌注分级;观察手术前后血高敏C反应蛋白(hs-CRP)、P选择素、细胞间黏附分子1(ICAM-1)、血肌酐、肌酐清除率(Ccr)水平。结果两组患者均顺利完成手术。术后强化组TIMI血流改善好于标准组(P<0.05),术后即刻校正的TIMI帧数计数明显低于标准组(P<0.01)。两组患者术后血清hs-CRP、P选择素和ICAM-1表达水平均上升,但强化组各项指标升高水平低于标准组(P<0.05)。强化组术后24 h、48 h血肌酐水平低于标准组(P<0.05),肌酐清除率高于标准组(P<0.01),对比剂肾病(CIN)发生率低于标准组(P<0.05)。结论早期强化瑞舒伐他汀治疗可改善ACS患者PCI术后心肌灌注,降低无复流、炎症反应的发生,并且加快肾功能恢复,降低CIN发病率,从而起到更有效保护心肾的功能。
Objective To evaluate the effects of intense rosuvastatin pretreatment on heart and renal function in patients with acute coronary syndrome （ ACS） undergoing percutanous coronary intervention （ PCI） .Methods One hundred patients with ACS were randomly divided into two groups ,intensive rosuvastatin group and standard rosuvastatin group ,50 cases in each group .Seven days before PCI ,the patients in the intensive rosuvastatin group were given rosuvastatin 20 mg/day,while patients in the standard rosuvastatin group were given rosuvastatin 10 mg/day.The TIMI blood flow, TIMI myocardial perfusion grade ,high sensitivity C-reactive protein（hs-CRP）,P-selectin,intercellular adhesion molecule 1（ICAM-1）,serum creatinine level and creatinine clearance were observed in both groups before and after the PCI . Results The operation was succeeded in both groups .After PCI,the TIMI blood flow in the intensive rosuvastatin group was better than that in the standard rosuvastatin group （P〈0.05）,the corrected TIMI frame count （CTFC） in the intensive rosuvastatin group was significantly lower than that in the standard rosuvastatin group （P〈0.01）.The levels of serum hs-CRP,P-selectin and ICAM-1 increased significantly in both groups after operation , but the increase was lower in the intensive rosuvastatin group compared with standard rosuvastatin group （P〈0.01）.The levels of serum creatinine 24,48 hours after operation in the intensive rosuvastatin group were lower than those in the standard rosuvastain group （ P〈0.05） , the creatinine clearance in the intensive rosuvastatin group was higher than that in the standard rosuvastain group （P〈0.01）,and the incidence of contrast induced nephropathy （CIN） in the intensive rosuvastatin group was lower than that in the standard rosuvastain group （ P〈0 .05 ） .Conclusion Intensive rosuvastatin pretreatment can improve＆amp;nbsp;myocardial perfusion in ACS patients undergoing PCI ,reduce the incidence of non-reflow and inflammatory response , promote the recovery of renal function , decrease the incidence of CIN , and then protect the heart and renal function effectively .
出处
《广西医学》
CAS
2014年第6期760-763,共4页
Guangxi Medical Journal
关键词
急性冠状动脉综合征
瑞舒伐他汀
经皮冠状动脉介入术
心肌灌注
对比剂肾病
Acute coronary syndrome
Rosuvastatin
Percutanous coronary intervention
Myocardial perfusion
Contrast induced nephropathy
