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目的探讨强化瑞舒伐他汀治疗对行经皮冠状动脉介入治疗(PCI)的非ST段抬高型急性冠脉综合征患者的作用。方法将入院初步诊断为冠心病非ST段抬高型急性冠状动脉综合征且符合该试验条件的患者随机分为强化组和常规剂量组,强化组自入院起连续服用瑞舒伐他汀20 mg/d直至术后1月,1月后改为常规剂量10 mg/d;常规剂量组自入院时即给予常规剂量瑞舒伐他汀10 mg/d直至随访结束。观察两组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高敏C反应蛋白(hs-CRP)、肌钙蛋白(cTnT)、肌酸激酶-同工酶(CK-MB)水平以及术后3个月内主要心脏不良事件的发生情况。结果两组基础情况和冠状动脉造影特征无明显差异;两组患者术前hs-CRP、cTnT、CK-MB基线值差异无统计学意义(P>0.05)。术后24h、术后7d及术后1月两组血浆hs-CRP峰值差异有统计学意义(P<0.05);术后24h、术后7d两组血浆cTnT、CK-MB水平差异有统计学意义(P<0.05);术后1月两组血浆cTnT、CK-MB水平差异无统计学意义(P>0.05)。术后3个月内强化组无心脏不良事件发生,而常规剂量组有4例,差异有统计学意义(P<0.05)。结论行PCI的非ST段抬高型急性冠脉综合征患者给予强化瑞舒伐他汀治疗能明显降低术后血浆hs-CRP、cTnT、CK-MB水平,并减少术后心血管事件的发生。
Objective To investigate the effect of intensive rosuvastatin on patients with non-ST elevation acute coronary syndrome undergoing percutaneous coronary intervention (PCI). Methods The patients diagnosed as CHD with non-ST-segment elevation acute coronary syndrome and admitted to the hospital were randomly divided into two groups: the intensive group and the conventional group. The patients in the intensive group received rosuvastatin 20 mg / d until January, January after the routine dose of 10 mg / d; conventional dose group from admission to the conventional dose of rosuvastatin 10 mg / d until the end of follow-up. The levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high sensitivity C-reactive protein (hs-CRP), troponin (cTnT), creatine kinase- (CK-MB) levels and the incidence of major cardiac adverse events within 3 months after surgery. Results There was no significant difference between baseline and coronary angiography in the two groups. There was no significant difference in baseline preoperative hs-CRP, cTnT and CK-MB between the two groups (P> 0.05). The peak plasma hs-CRP levels at 24 h, 7 d and 1 month after operation were significantly different between the two groups (P <0.05). The plasma levels of cTnT and CK-MB at 24 h and 7 d after operation were statistically different (P <0.05). There was no significant difference in plasma levels of cTnT and CK-MB between January and January (P> 0.05). There were no cardiac adverse events in the intensive group within 3 months after operation, compared with 4 in the conventional dose group (P <0.05). Conclusion Patients with non-ST-segment elevation acute coronary syndrome treated with intensive rosuvastatin can significantly reduce the levels of plasma hs-CRP, cTnT, CK-MB and reduce postoperative cardiovascular events.