摘要
目的评估在PCI围术期接受负荷剂量阿托伐他汀治疗对合并睡眠呼吸暂停综合征(sleepapnea syndrome,SAS)冠心病患者炎症状态和心脏功能的改善效果。方法最终纳入102例冠心病伴SAS患者,随机分为3组:A组(n=32)在PCI前服用阿托伐他汀80 mg/d,PCI术后调整剂量为40 mg/d,4周后调整为20 mg/d,持续20周;B组(n=32)在PCI术前未接受阿托伐他汀治疗,但在PCI术后服用阿托伐他汀40 mg/d,连续服用4周后剂量调整为20 mg/d,持续20周;C组(n=38)仅在PCI术后服用阿托伐他汀20 mg/d,持续24周。分别在入院(第0天)和PCI术后1 d、7 d、4周、24周检测患者外周血hs-CRP、BNP和MMP-9水平,以及在PCI术后第3天和24周进行超声心动图检查。结果 3组入院时基线资料、炎症因子水平之间均无明显差异(P>0.05)。与C组相比,在阿托伐他汀治疗期间A组不同时间点hs-CRP、BNP和MMP-9水平均明显降低(P<0.05),B组在PCI术后7 d的MMP-9水平明显降低(P<0.05),A组和B组在PCI术后24周的LVEF明显升高(P<0.05)。结论 PCI术前加载负荷剂量阿托伐他汀治疗有助于预防SAS合并冠心病患者接受PCI治疗的炎症反应并改善心脏功能。
Objective To assess the effect of perioperative dose atorvastatin on inflammatory status and cardiac function in patients with coronary heart disease complicated by sleep apnea syndrome （SAS） during periop- erative period. Methods A total of 102 patients were enrolled into 3 groups. Group A （n = 32） received 80 mg of atorvastatin before PCI, post-PCI follow-up atorvastatin 40 mg for 4 weeks, and atorvastatin 20 nag for 20 weeks ; group B （n = 32） received no pre-PCI loading dose of atorvastatin but received atorvastatin 40 mg for 4 weeks and then atorvastatin 20 nag for 20 weeks; and group C （n = 38） received only post-PCI atorvastatin 20 mg for 24 weeks. Venous blood samples were collected into Vaeutainer tubes from fasting patients on admission （day 0 ）, and 1 day, 7 days, 4 weeks, and 24 weeks after PCI to measure BNP, MMP-9 and hs-CRP. All the patients underwent echoeardiographic assessment on the third day after primary PCI and at the 24th week after a follow-up. Results No differences were found in baseline demographic and angiographic characteristics, and inflammatory factor among the 3 groups. As compared with group C, the average levels of hs-CRP, BNP and MMP-9 in group A de- creased significantly （P 〈 0.05 ） at different time points during atorvastatin treatment （PCI）, and the average level of MMP-9 in group B decreased significantly （P 〈 0.05 ） after 7 days. At 24 weeks after PCI, LVEF was significant- ly higher in group A and group B than in group C （P 〈 0.05）. Conclusions Additional loading-dose atorvastatin before PCI may help prevent inflammatory response and improve cardiac function in patients with SAS complicated by coronary heart disease undergoing PCI.
出处
《实用医学杂志》
CAS
北大核心
2018年第2期269-272,276,共5页
The Journal of Practical Medicine
基金
河南省卫生厅科技攻关项目(编号:20140537)
关键词
睡眠呼吸暂停综合征
阿托伐他汀
冠心病
炎症状态
心脏功能
sleep apnea syndrome
atorvastatin
coronary heart disease
inflammation status
car-diac function
