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目的观察已接受长期他汀治疗的稳定型心绞痛患者,经皮冠状动脉介入术(percutaneous coronary interven-tion,PCI)前单次服用80 mg阿托伐他汀能否降低术后炎症反应、血小板活性以及主要不良心脏事件(major adverse cardiacevents,MACE)的发生。方法选择2010年1月至2011年7月在本科接受PCI术的稳定型心绞痛患者115例,年龄(59.23±10.23)岁,男性83例,女性32例。随机分为2组:强化组(n=56)在PCI术前12 h给予单次负荷剂量(80 mg)阿托伐他汀;对照组(n=59)在PCI术前12 h予常规剂量(20 mg)阿托伐他汀治疗。观察2组患者术前24 h及术后24 h血白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、高敏C反应蛋白(hs-CRP)及血小板α颗粒膜蛋白(GMP140)、p-选择素(CD62p)水平,并随访所有患者术后30 d内MACE的发生情况。结果 2组术前24 h各指标无差异(P>0.05)。强化组术后24 h炎症因子及血小板活化因子显著低于对照组(P<0.05);强化组炎症因子及血小板活化因子水平在PCI术后较术前显著下降(P<0.05)。对照组术后较术前有一定程度的升高(P>0.05);术后30 d强化组MACE发生率显著低于对照组(P<0.05)。结论对于已接受长期他汀治疗的稳定型心绞痛患者,PCI术前12 h再给予单次80 mg阿托伐他汀能显著降低炎症因子、血小板活化因子及MACE的发生。
Objective To investigate whether percutaneous coronary intervention (percutaneous coronary intervention, PCI) 80 mg atorvastatin can reduce postoperative inflammatory response, platelet activity and the main The occurrence of major adverse cardia events (MACE). Methods A total of 115 stable angina patients undergoing PCI from January 2010 to July 2011 were enrolled in this study. Their ages (59.23 ± 10.23) years were 83 males and 32 females. The patients in the intensive group (n = 56) received atorvastatin at a single loading dose (80 mg) 12 h before PCI and the control group (n = 59) at 12 h before PCI. 20 mg) atorvastatin treatment. The levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), high sensitivity C-reactive protein (hs-CRP) and platelet α-granule membrane (GMP140) and p-selectin (CD62p) were measured. All patients were followed up for MACE within 30 days after operation. Results There was no difference in each index between the two groups before surgery (P> 0.05). The levels of inflammatory cytokines and platelet activating factor in the intensive group at 24 h after operation were significantly lower than those in the control group (P <0.05). The levels of inflammatory cytokines and platelet activating factor in the intensive group were significantly lower than those before operation (P <0.05). The control group had a certain degree of postoperative increase compared with that before operation (P> 0.05). The incidence of MACE in the intensive group at 30 days after operation was significantly lower than that in the control group (P <0.05). Conclusions For patients with stable angina who have received long-term statin therapy, a single 80 mg atorvastatin 12 h before PCI significantly reduces the incidence of inflammatory cytokines, platelet-activating factor and MACE.