作　　者： (张晓）; (朱鑫）;

机构地区： 郑州大学第一附属医院心内科,河南郑州450000

出　　处： 《河南医学研究》 2017年第17期3078-3080,共3页

摘　　要： 目的探讨负荷量加高维持量的瑞舒伐他汀对不稳定性心绞痛患者经皮冠状动脉介入治疗(PCI)相关炎症反应及心肌损伤的影响。方法将120例不稳定性心绞痛患者随机分为负荷加高维持量组(观察组)60例和常规治疗组(对照组)60例。两组患者术前均未服用降脂药物,均给予常规药物治疗和PCI。观察组在PCI术前加用瑞舒伐他汀20 mg并于PCI术后维持此剂量30 d,对照组在PCI术前加用瑞舒伐他汀10 mg并于PCI术后维持此剂量30 d。检测两组患者术前、术后次日及术后30 d的血CK-MB、CTn T、hs-CRP、IL-6、IL-18水平及术后30 d内心脏不良事件的发生情况。结果两组患者PCI术后次日血CK-MB、CTn T、hs-CRP、IL-6、IL-18水平均较术前升高(P<0.05),两组间比较,差异无统计学意义(P>0.05)。两组患者术后30 d血CK-MB、CTn T、hs-CRP、IL-6、IL-18水平降低,与对照组相比,观察组血hs-CRP、IL-6、IL-18水平较低,差异有统计学意义(P<0.05)。观察组术后30 d内心源性再住院及心绞痛复发率较对照组下降,差异有统计学意义(P<0.05)。结论负荷加高维持量瑞舒伐他汀可有效抑制不稳定性心绞痛患者PCI术后的炎症反应,减少心血管事件的发生。 Objective To explore the effects of elevated maintenance dose of rosuvastatin on PCI related inflammatory response and myocardial injury in patients with unstable angina pectoris. Methods One hundred and twenty patients with unstable angina pectoris were randomly divided into observation group （60 cases, treated with elevated maintenance dose of rosuvastatin） and control group （60 cases, treated with routine dose of rosuvastatin）. Two groups of patients were not taken lipid -lowering drugs before operation, and they were given routine medication and PCI. In the observation group, rosuvastatin （20 rag） was added before operation, and the dose was maintained for 30 days after PCI. The control group received rosuvastatin （ 10mg） be- fore PCI, and the dose was maintained for 30 days after PCI. The blood levels of CK - MB, CTnT, hs - CRP, IL - 6, IL - 18 before operation , 1 day and 30 days after operaion and the adverse events within 30 days after operation were detected in two groups. Results The blood levels of CK - MB, CTnT, hs - CRP, IL - 6, IL - 18 on t^he 1 st day after operaion were higher than before operation in two groups （ P 〈 0. 05 ）, but there were no differences between two groups （ P 〉 0. 05 ）. The blood levels of CK - MB, CTnT, hs -CRP, IL -6, IL- 18 on the 30 days after operaion were lower than the 1st day after operaion in two groups （P 〈0. 05） , and the blood levels of hs - CRP, IL -6, IL - 18 in observation group were lower than control group （P 〈0. 05）. The cardiogenic readmission rate and recurrence rate of angina pectoris in 30 days after operation in observation group were lower than control group （ P 〈 0.05 ）. Conclusion Load heightening maintenance dose of rosuvastatin can effectively inhibit the insta- bility of inflammatory reaction in patients with angina pectoris after PCI operation, reduce the incidence of cardiovascular events.

关 键 词： 瑞舒伐他汀 不稳定性心绞痛 经皮冠状动脉介入治疗 心肌损伤