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目的通过观察血清高敏C反应蛋白(hs-CRP)、可溶性CD40L(sCD40L)等指标变化,探讨在急性心肌梗死(AMI)急诊经皮冠状动脉介入治疗(PCI)围术期他汀类药物强化治疗的效果及意义。方法将112例行急诊PCI治疗的AMI患者随机分为治疗1组40例(术前服阿托伐他汀80mg,术后服阿托伐他汀40mgqd)、治疗2组40例(术前服阿托伐他汀40mg,术后服阿托伐他汀20mgqd)和对照组32例(常规治疗),3组基线资料具有可比性。分别测定3组PCI术后血清hs-CRP、sCD40L及肌酸激酶同工酶(CK-MB)水平。结果与对照组比较,治疗1组和治疗2组PCI治疗后12h、24h、7d血清hs-CRP、sCD40L水平均明显下降(P均<0.01),治疗1组和治疗2组之间差异有统计学意义(P均<0.01)。2个治疗组术后12、24h的CK-MB升高>2倍正常值上限的患者发生率均较对照组明显降低(P均<0.05),2个治疗组比较差异亦有统计学意义(P均<0.05)。结论 AMI患者急诊PCI围术期强化他汀类药物治疗,可能通过抗炎、抗血小板、稳定冠脉血管内皮及粥样斑块等作用,使患者获益。
Objective To observe the changes of serum hs-CRP and sCD40L in patients undergoing percutaneous coronary intervention (PCI) with acute myocardial infarction (AMI) during perioperative period of statin therapy Effect and significance. Methods One hundred and twelve patients with acute myocardial infarction (AMI) treated with emergency PCI were randomly divided into treatment group (n = 40), treated with atorvastatin 80 mg and atorvastatin 40 mg qd postoperatively Statin 40mg, postoperative atorvastatin 20mgqd) and control group 32 cases (routine treatment), three groups of baseline data is comparable. Serum levels of hs-CRP, sCD40L and creatine kinase MB (CK-MB) were measured in 3 groups after PCI respectively. Results Compared with the control group, the levels of serum hs-CRP and sCD40L at 12h, 24h and 7d after treatment in treatment group 1 and treatment group 2 were significantly decreased (all P <0.01), there was statistical difference between treatment group 1 and treatment group 2 Significance (P <0.01). The incidence of patients with elevated CK-MB> 2-fold upper limit of normal in two treatment groups at 12 and 24 hours after operation was significantly lower than that in control group (all P <0.05), and the differences between the two treatment groups were also statistically significant P <0.05). Conclusions Patients undergoing AMI in intensive care perioperative intensive statin therapy may benefit from anti-inflammatory, anti-platelet, stable coronary endothelium and atherosclerotic plaque.