论文部分内容阅读
目的:探讨阿托伐他汀强化治疗对冠脉介入冠心病患者的保护作用。方法:将86例择期行经皮冠脉介入(PCI)治疗的冠心病患者随机分为对照组和观察组,每组各43例。两组均行常规治疗,对照组在PCI术后服用阿托伐他汀20 mg/d,观察组在PCI术前服用阿托伐他汀80 mg,术后服用阿托伐他汀20 mg/d,术后两组均维持服用4周。比较PCI术前、术后患者血小板活化、内皮功能及血清肌酸激酶同工酶(CK-MB)、肌钙蛋白I(c TNI)、超敏C反应蛋白(hs-CRP)水平的变化。结果:术前及术后24 h,两组间血小板活化指标P-选择素(CD62P)和血小板膜糖蛋白Ⅱb/Ⅲa(GPⅡb/Ⅲa)水平比较差异无统计学意义(P>0.05),术后4周,两组患者CD62P和GPⅡb/Ⅲa水平均较术前及术后24 h显著降低,且观察组降低更显著(P<0.05);术前及术后24 h,两组间内皮功能指标内皮素1(ET-1)、一氧化氮(NO)水平比较差异无统计学意义(P>0.05);术后4周,两组患者ET-1水平均较术前及术后24 h显著降低,NO水平均显著升高,且观察组改变更显著(P<0.05);术后24 h,两组患者的血清CK-MB、TNI和hs-CRP水平均较术前显著升高(P<0.05),但观察组升高幅度明显低于对照组(P<0.05)。结论:阿托伐他汀强化治疗可抑制PCI术后血小板活化,改善血管内皮功能,抑制炎症反应,减少心肌损伤。
Objective: To investigate the protective effects of atorvastatin on coronary artery disease patients with coronary artery disease. Methods: Eighty-six patients with coronary artery disease undergoing percutaneous coronary intervention (PCI) were randomly divided into control group and observation group, with 43 cases in each group. The patients in the control group received atorvastatin 20 mg / d after PCI, the observation group took atorvastatin 80 mg before PCI, and atorvastatin 20 mg / d after operation The last two groups were maintained for 4 weeks. The changes of platelet activation, endothelial function and serum CK-MB, c TNI, and hs-CRP in patients before and after PCI were compared. Results: There was no significant difference in the levels of P-selectin (CD62P) and platelet glycoprotein Ⅱb / Ⅲa (GPⅡb / Ⅲa) between the two groups before and 24 hours after operation After 4 weeks, the levels of CD62P and GPⅡb / Ⅲa in both groups were significantly lower than those of preoperative and postoperative 24 h and significantly lower in the observation group (P <0.05) The levels of ET-1 and NO were not significantly different between the two groups (P> 0.05). At 4 weeks after operation, ET-1 levels in both groups were significantly higher than those before and 24 h (P <0.05). Serum levels of CK-MB, TNI and hs-CRP were significantly increased in both groups at 24 h after operation (P <0.05) P <0.05), but the observation group increased significantly lower than the control group (P <0.05). Conclusion: Atorvastatin can inhibit platelet activation after PCI, improve endothelial function, inhibit inflammation and reduce myocardial damage.