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目的探讨负荷剂量阿托伐他汀对非ST段抬高急性冠状动脉综合征(NSTE-ACS)患者经皮冠状动脉介入治疗(PCI)后的影响。方法将2009年6—10月山东大学齐鲁医院收集的81例NSTE-ACS患者随机分为负荷组和对照组,负荷组PCI前12h顿服阿托伐他汀80mg,术前2h追加阿托伐他汀40mg。所有患者于术前和术后8h、24h抽取肘静脉血检测肌酸激酶同工酶(CK-MB)、血浆肌钙蛋白(cTNI)和超敏C反应蛋白(hs-CRP)、肌酸激酶(CK)、转氨酶(ALT/AST)。结果 PCI术后2组心肌损伤及炎性反应标志物均有不同程度升高,但负荷组CK-MB、cTNI和hs-CRP水平显著低于对照治疗组(均P<0.01)。负荷组主要不良心脏事件发生率(2.4%)小于对照组(22.5%)(P=0.0161),主要由心肌梗死发生率下降(2.4%对20.0%,P=0.0307)构成。2组患者药物副反应轻微。结论 PCI前阿托伐他汀负荷剂量能减少PCI对NSTE-ACS患者造成的心肌损伤及炎症反应。降低PCI后不良心脏事件的发生,且安全有效。
Objective To investigate the effect of atorvastatin loading on percutaneous coronary intervention (PCI) in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). Methods Eighty-one patients with NSTE-ACS collected from Qilu Hospital of Shandong University from June to October in 2009 were randomly divided into the control group and the control group. The patients in the control group received atorvastatin 80 mg 12 hours before PCI and atorvastatin 40mg. All the patients were given elbow venous blood before and 8h and 24h after operation for determination of creatine kinase (CK-MB), plasma cTNI, hs-CRP, creatine kinase (CK), transaminase (ALT / AST). Results The levels of CK-MB, cTNI and hs-CRP in myocardial infarction group were significantly lower than those in control group (all P <0.01). The incidence of major adverse cardiac events (2.4%) in the load group was less than that in the control group (22.5%) (P = 0.0161) and was mainly due to a decreased incidence of myocardial infarction (2.4% vs. 20.0%, P = 0.0307). Two groups of patients with minor side effects of drugs. Conclusions Atorvastatin loading dose before PCI can reduce myocardial injury and inflammation caused by PCI in patients with NSTE-ACS. Reduce the incidence of adverse cardiac events after PCI, and safe and effective.