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目的:探讨强化阿托伐他汀治疗对经皮冠状动脉介入治疗术(percutaneous coronary intervention,PCI)围手术期心肌损伤的即刻保护作用。方法:选择本院择期行PCI术的冠心病(coronary artery disease,CAD)患者60例,随机分为常规治疗组28例,强化他汀治疗组32例。在术前、术后24 h分别测定肌酸激酶MB(creatine kinase-MB,CK-MB)、肌钙蛋白T(cTroponinT,cTnT)。结果:常规及强化他汀治疗组中,PCI术后24 h CK-MB>3倍正常参考值上限(3UNL)(14.3%vs 9.4%,OR:0.62,95%CI:0.13～3.05,P=0.695)及CK-MB>1 UNL(21.4%vs 9.4%,OR:0.38,95%CI:0.09～1.69,P=0.281)的发生率比较无统计学意义,cTnT>3 UNL(7.1%vs 6.3%,OR:0.88,95%CI:0.11～6.59,P=1.000)及cTnT>1 UNL的发生率(14.3%vs 12.5%,OR:0.86,95%CI:0.19～3.80,P=1.000)无统计学差异。结论:PCI围手术期给予阿托伐他汀强化治疗没有降低围手术期心肌坏死及梗死的发生率。
Objective: To investigate the immediate protective effect of enhanced atorvastatin on myocardial injury during percutaneous coronary intervention (PCI). Methods: Sixty patients with coronary artery disease (CAD) undergoing elective PCI in our hospital were randomly divided into routine treatment group (n = 28) and intensive statin treatment group (n = 32). The levels of creatine kinase-MB (CK-MB) and cTroponin T (cTnT) were measured before operation and 24 hours after operation. Results: In the conventional and intensive statin groups, the upper limit of 3-fold CK-MB> 3 times the normal reference value (14.3% vs 9.4%, OR: 0.62, 95% CI: 0.13-3.05, P = 0.695 ) And CK-MB> 1 UNL (21.4% vs 9.4%, OR: 0.38,95% CI: 0.09-1.69, P = 0.281). There was no significant difference in the incidence of cTnT> 3 UNL (7.1% vs 6.3% , OR: 0.88, 95% CI: 0.11-6.59, P = 1.000) and cTnT> 1 UNL (14.3% vs 12.5%, OR: 0.86, 95% CI: 0.19-3.80, P = 1.000) Differences Conclusion: Perioperative atorvastatin given peritoneal PCI did not reduce the incidence of perioperative myocardial necrosis and infarction.