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目的观察阿托伐他汀对冠状动脉粥样硬化性心脏病(CHD)患者冠状动脉支架植入术后支架内膜增生的影响。方法选取2014年5月至2016年2月于深圳市孙逸仙心血管医院接受冠状动脉支架植入术治疗的CHD患者117例为研究对象,按照随机数字表法分为观察组58例和对照组59例。所有患者均接收规范的CHD二级预防方案治疗,对照组行常规及阿托伐他汀20 mg,每日1次治疗,观察组行常规及阿托伐他汀40 mg,每日1次治疗,记录两组患者冠状动脉支架植入术后即刻及6~9个月后复查冠状动脉造影时支架内的最小冠状动脉血管直径和内膜增生面积及更少的最小管腔面积。结果两组患者均未发生心脏不良事件和再次支架植入。其中观察组112处病变植入支架,对照组91处病变植入支架,且均完成了造影随访。观察组与对照组支架内晚期管腔丢失和节段内晚期管腔丢失比较差异均有统计学意义(均P<0.05)。观察组的冠状动脉支架内平均内膜增生面积与对照组比较,差异有统计学意义(P<0.05)。结论大剂量阿托伐他汀可以减少冠状动脉支架术后支架内管腔直径丢失和内膜增生,进而预防再狭窄发生。
Objective To observe the effect of atorvastatin on stent intimal hyperplasia after coronary stent implantation in patients with coronary atherosclerotic heart disease (CHD). Methods A total of 117 CHD patients undergoing coronary stent implantation at Sun Yat-sen Cardiovascular Hospital of Shenzhen City from May 2014 to February 2016 were selected and divided into observation group (58 cases) and control group (59 cases) according to random number table example. All patients received standardized treatment of CHD secondary prevention programs, the control group routine and atorvastatin 20 mg, 1 day treatment, observation group routine and atorvastatin 40 mg, 1 treatment daily, record Two groups of patients undergoing coronary stenting immediately after surgery and 6 to 9 months after coronary angiography coronary stent diameter of the smallest coronary artery and intimal hyperplasia area and less the smallest lumen area. Results No adverse cardiac events and stent implantation occurred in either group. One hundred and twelve lesions in the observation group were implanted in the scaffold, and 91 in the control group were implanted with the scaffold. All of them were followed up by angiography. There was significant difference between late stent loss and late stent loss in observation group and control group (all P <0.05). The mean intimal hyperplasia area in the coronary stent in the observation group was significantly different from that in the control group (P <0.05). Conclusions High-dose atorvastatin can reduce the loss of lumen diameter and intimal hyperplasia after stent implantation in order to prevent the occurrence of restenosis.