标题：不同剂量阿托伐他汀对急性冠脉综合征PCI术后血清炎症因子和心血管事件的影响

      作者：肖亚利，王金艳，孟祥茹，赵敏，吕平，崔涛
    (涿州市医院心内科，河北 涿州 072750)

      卷次： 2016年27卷10期

      【摘要】 目的 探讨不同剂量阿托伐他汀治疗对急性冠脉综合征(ACS)患者经皮冠状动脉介入(PCI)术后血
清炎症因子和心血管事件的影响。方法 选取2014年1月至2015年8月我院90例ACS择期行PCI术治疗的患者，
按照随机数表法随机分为常规剂量组(给予阿托伐他汀20 mg/d)和强化剂量组(给予阿托伐他汀80 mg/d)各45例。
分别检测两组患者在治疗前和治疗后4 h、1 d、7 d的血脂、血清超敏C反应蛋白(hs-CRP)、白细胞介素-6 (IL-6)、肌
钙蛋白 I (cTnI)及肌酸激酶同工酶(CK-MB)水平，并比较两组患者PCI术后的主要心血管事件的发生情况。结果 常
规剂量组和强化剂量组PCI术后7 d血清TC、LDL-C、cTnI及CK-MB水平均明显低于术前、PCI术后4 h及术后1d，
差异均有统计学意义(P<0.05)；强化剂量组术后 7 d血清TC水平为(4.36±0.75) mmol/L，明显低于常规剂量组的
(4.83±0.87) mmol/L，而血清HDL-C水平为(1.20±0.36) mmol/L，高于常规剂量组的（1.12±0.28）mmol/L，差异均有统
计学意义(P<0.05)。强化剂量组术后4 h、1 d及7 d血清cTnI、CK-MB水平均明显低于常规剂量组，差异均有统计学意义
(P<0.05)；常规剂量组和强化剂量组PCI术后4 h血清Hs-CRP、IL-6水平明显高于术前、术后1 d及术后7 d，差异均有统计
学意义(P<0.05)；强化剂量组PCI术后4 h、1 d、7 d血清Hs-CRP水平分别为(15.78±3.15) mg/L、(12.28±2.03) mg/L和
(9.84±1.50) mg/L，明显低于常规剂量组的(18.40±4.27) mg/L、(13.74±2.25) mg/L和(0.76±1.82) mg/L，且强化剂量组
PCI术后 7 d血清 IL-6水平为(7.60±1.14) ng/L，明显低于常规剂量组(8.94±1.31) ng/L，差异均有统计学意义(P<
0.05)。强化剂量组术后3个月再发心肌梗死、再发心绞痛、再次入院数明显低于常规剂量组，差异均有统计学意义
(P<0.05)。结论 强化剂量阿托伐他汀可更明显降低ASC患者PCI术后血脂和炎症因子水平，改善心功能，减少心
血管不良事件的发生。

      【关键词】 阿托伐他汀；急性冠脉综合征；经皮冠状动脉介入术；炎症因子；心血管事件

      【中图分类号】 R541.4 【文献标识码】 A 【文章编号】 1003—6350（2016）10—1593—04


Effects of different doses of atorvastatin on serum inflammatory factors and cardiovascular events in patients
with acute coronary syndrome after percutaneous coronary intervention.
XIAO Ya-li, WANG Jin-yan, MENG
Xiang-ru, ZHAO Min, LV Ping, CUI Tao. Department of Cardiology, Zhuozhou Hospital, Zhuozhou 072750, Hebei, CHINA

【Abstract】 Objective To explore the effects of different doses of atorvastatin on serum inflammatory factors
and cardiovascular events after percutaneous coronary intervention (PCI) for patients with acute coronary syndrome
(ACS). Methods From January 2014 to August 2015, a total of 90 ACS patients undergoing elective PCI surgeries
were randomly and equally divided into routine dose group (20 mg/d of atorvastatin) and strengthening dose group
(80 mg/d of atorvastatin). Before treatment, and 4 h, 1 day and 7 days after treatment, the levels of blood lipid, serum hy-
persensitive c-reactive protein (hs-CRP), interleukin-6 (IL-6)，troponin I (cTnI) and creatine kinase isoenzyme
(CK-MB) were assayed in the two groups. The occurrences of PCI postoperative major cardiovascular events were
compared. Results The levels of serum TC, LDL-C, cTnI and CK-MB in two groups of PCI postoperative 7 d were
significantly lower than preoperative, PCI postoperative 1 day and 4 h, and the differences were statistically significant (P<
0.05). Seven days after treatment, the serum TC level of strengthening dose group [(4.36±0.75) mmol/L] was significantly
lower than routine dose group [(4.83±0.87) mmol/L], but the serum HDL-C level of strengthening dose group [(1.20±0.36)
mmol/L] was higher than routine dose group [(1.12±0.28) mmol/L], with statistically significant differences (P<0.05). 4
h, 1 d and 7 d after treatment, the levels of serum cTnI and CK-MB in strengthening dose group were significantly lower
than the routine dose group, and the differences were statistically significant (P<0.05). The levels of serum hs-CRP and
IL-6 level in two groups 4 h after treatment were significantly higher than those before treatment, and 1 d, 7 d after treat-
ment, and the differences were statistically significant (P<0.05). 4 h, 1 d and 7 d after treatment, the levels of serum
hs-CRP in strengthening dose group [(15.78±3.15) mg/L, (12.28±2.03) mg/L and (9.84±1.50) mg/L] were significantly
lower than those in routine dose group [(18.40±4.27) mg/L, (13.74±2.25) mg/L and (0.76±1.82) mg/L]. Moreover, the
·论 著·
6350.2016.10.015