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目的观察经皮冠状动脉介入术(PCI)前12h服用80mg阿托伐他汀(立普妥),联合术前2h加服40mg阿托伐他汀,降低围手术期患者心肌梗死(MI)的发生率对预后的影响。方法 120例需择期PCI的患者随机分为阿托伐他汀强化组和对照组。阿托伐他汀强化组:给予冠状动脉粥样硬化性心脏病(冠心病,CHD)基础药物治疗的同时,术前12h给予阿托伐他汀80mg,术前2h阿托伐他汀40mg;对照组:仅给予CHD基础药物治疗,其中阿托伐他汀20mg。测定PCI术后18h测肌钙蛋白I(TnI)、肌酸激酶同工酶(CK-MB),并随访术后30d的主要心血管不良事件(MACE:心血管死亡、再发心肌梗死和靶血管重建)。结果阿托伐他汀强化组心肌梗死标志物水平显著低于对照组,CK-MB和TnI分别为(2.21±0.77)ng/ml比(12.30±7.89)ng/ml(P<0.01),和(0.196±0.112)ng/ml比(1.359±0.142)ng/ml,(P<0.01);且术后30d,阿托伐他汀强化组(3.08%)的主要不良心脏事件明显低于对照组(9.09%)比,P<0.01。结论对于稳定型心绞痛患者,PCI术前12h给予阿托伐他汀80mg,术前2h加服40mg,能显著降低PCI围术期MI的发生率,改善预后。
Objective To observe the effect of percutaneous coronary intervention (PCI) on 80% atorvastatin (Lipitor) combined with 40 mg of atorvastatin 2 h before percutaneous coronary intervention (PCI) to reduce the incidence of perioperative myocardial infarction (MI) Impact on prognosis. Methods A total of 120 patients with elective PCI were randomly divided into atorvastatin-treated group and control group. Atorvastatin intensive group: given atherosclerosis heart disease (coronary heart disease, CHD) while the basic drug treatment, at 12h before surgery to give atorvastatin 80mg, 2h before surgery atorvastatin 40mg; control group: Only given CHD basic drugs, including atorvastatin 20mg. Cardiac troponin I (TnI) and creatine kinase isoenzyme (CK-MB) were measured at 18 h after PCI and were followed up for 30 days. Cardiovascular adverse events (MACE: Cardiovascular death, recurrent myocardial infarction and target Revascularization). Results Compared with the control group, the levels of CK-MB and TnI in atorvastatin-treated group were (2.21 ± 0.77) ng / ml (12.30 ± 7.89) ng / ml, 0.196 ± 0.112) ng / ml (1.359 ± 0.142) ng / ml, (P <0.01), and the major adverse cardiac events in the atorvastatin-treated group (3.08%) were significantly lower than those in the control group %) Than that of P <0.01. Conclusions For patients with stable angina pectoris, atorvastatin 80 mg 12 h before PCI and 40 mg 2 h before PCI can significantly reduce the incidence of perioperative MI and improve the prognosis.