摘要
目的观察不同剂量阿托伐他汀对非体外循环冠脉旁路移植术(off-pump coronary artery bypass grafting,OPCAB)后患者认知功能的影响。方法随机将拟行OPCAB患者分为强化他汀组(55例)和常规他汀组(50例),分别给予阿托伐他汀(立普妥)40 mg/d和20 mg/d,用药自术前1周至术后21 d。评估2组患者术后7 d、21 d认知功能及术后认知功能障碍(postoperative cognitive dysfunction,POCD)发生率。结果与常规他汀组比较,强化他汀组术后第7、21天累加测试、循迹连线测试及术后21 d数字广度测试差异均有统计学意义(P<0.05)。强化他汀组和常规他汀组术后7 d POCD发生率分别为30.91%和54.00%,术后21 d POCD发生率分别为3.64%和18.00%,差异均有统计学意义(P<0.05)。结论40 mg/d阿托伐他汀较20 mg/d明显改善OPCAB患者术后认知功能,减少术后7 d、21 d POCD发生率,且不增加不良反应发生率,强化他汀治疗安全有效。
Objective To investigate the effects of different doses of atorvastatin on cognitive function after off-pump coronary artery bypass(OPCAB).Methods Patients with OPCAB were randomly divided into the intensive statin group(55 cases)and the conventional statin group(50 cases).Patients were given atorvastatin(Lipitor)40mg/d and 20mg/d,respectively,from 1 week before operation to 21 days after operation.The incidence of cognitive function and postoperative cognitive dysfunction(POCD)was evaluated at the 7th and 21st day after operation.Results There were significant differences in the cumulative test,the tracking test and the digit span test on the 7th and 21st day after operation between the two groups(P<0.05).The incidences of POCD were 30.91%and 54.00%in the intensive statin group and the routine statin group,respectively,and 3.64%and 18.00%in the 21 days postoperatively.The difference was statistically significant(P<0.05).Conclusion Compared with 20mg/d,40mg/d atorvastatin significantly improved the postoperative cognitive function of OPCAB patients,reduced the incidence of POCD at the 7th and 21st,and did not increase the incidence of adverse reactions.Intensive statin therapy is safe and effective.
作者
张宪芬
韩婉青
张殿宝
曹劝省
陶欢欢
王永生
ZHANG Xianfen;HAN Wanqing;ZHANG Dianbao;CAO Quanxing;TAO Huanhuan;WANG Yongsheng(The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,China)
出处
《中国实用神经疾病杂志》
2020年第22期2003-2008,共6页
Chinese Journal of Practical Nervous Diseases
基金
河南省医学科技攻关计划联合共建项目(编号:2018020288)。
