摘要
目的分析不同剂量匹伐他汀对急性冠脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术后正五聚蛋白3(PTX3)水平和再灌注心肌损伤的影响。方法选取2021年1月至2021年12月于沧州市中心医院行择期PCI的ACS患者86例为研究对象,采用随机数字表分为常规组及强化组,每组各43例,常规组给予匹伐他汀钙片常规剂量(2mg/d),强化组给予匹伐他汀钙片强化剂量治疗(4mg/d)。比较PCI术前及术后1d、7d心肌损伤指标[肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、同型半胱氨酸(Hcy)]、炎症因子[PTX-3、超敏C反应蛋白(hs-CRP)]、血脂[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]变化情况,并记录两组药物相关不良反应及术后28d主要不良心血管事件(MACE)的发生情况。结果两组PCI手术前后cTnI、CK-MB、Hcy、PTX-3、hs-CRP比较,差异具有统计学意义(P<0.05);术后1d时,两组cTnI、CK-MB、Hcy、PTX-3、hs-CRP均较术前升高(P<0.05),术后1d及术后7d时,强化组上述指标均低于常规组(P<0.05)。两组PCI手术前后TC、TG、LDL-C、HDL-C比较,差异均无统计学意义(P>0.05);常规组围术期TC、TG、LDL-C、HDL-C无明显变化(P>0.05),术后7d,强化组TC较术前及术后1d降低(P<0.05),且低于同期常规组(P<0.05)。两组药物相关不良反应总发生率及主要不良心血管事件总发生率比较,差异无统计学意义(P>0.05)。结论PCI围术期给予4mg/d匹伐他汀强化治疗,能减轻ACS患者术后炎症反应及心肌损伤,且不良反应少,可能对PCI术后转归更为有利。
Objective To analyze the influence of different doses of pitavastatin on level of pentraxin 3(PTX3)and reperfusion myocardial injury in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods ACS patients undergone PCI(n=86)were chosen from Central Hospital of Cangzhou City from Jan.2021 to Dec.2021,and divided into routine group and intensive group(each n=43)by using random digital table.The routine group was treated with pitavastatin calcium tablets in routine dose(2mg/d)and intensive group was treated with pitavastatin calcium tablets in intensive dose(4mg/d).The changes of indexes of myocardial injury[cardiac troponin I(cTnI),creatine kinase-MB isoenzyme(CK-MB),homocysteine(Hcy)],inflammatory factors[PTX-3,high sensitivity C-reactive protein(hs-CRP)],blood fat[total cholesterol(TC),triglyceride(TG),low-density lipoprotein-cholesterol(LDL-C),high-density lipoprotein-cholesterol(HDL-C)]were compared in 2 groups before and 1d and 7d after PCI.The adverse reactions related to drugs and major adverse cardiovascular events(MACE)28d after PCI were recorded in 2 groups.Results The differences in cTnI,CK-MB,Hcy,PTX-3 and hs-CRP had statistical significance in 2 groups before and after PCI(P<0.05).After PCI for 1d,cTnI,CK-MB,Hcy,PTX-3 and hs-CRP increased in 2 groups(P<0.05),and were lower in intensive group than those in routine group 1d and 7d after PCI(P<0.05).The differences in TC,TG,LDL-C and HDL-C had no statistical significance in 2 groups before and after PCI(P>0.05).In routine group,TC,TG,LDL-C and HDL-C had no significant changes in perioperative period(P>0.05).In intensive group,TC decreased 7d after PCI than that 1d after PCI(P<0.05)and was lower than that in routine group(P<0.05).The differences in the total incidence rates of adverse reactions related to drugs and MACE had no statistical significance between 2 groups(P>0.05).Conclusion The intensive treatment of pitavastatin(4mg/d)during perioperative period of PCI can relieve postoperative inflammatory responses and myocardial injury with few adverse reactions,which may be more beneficial to outcomes after PCI in ACS patients.
作者
郭润
王君
郑楠
吴婷婷
万艳芳
张军
Guo Run;Wang Jun;Zheng Nan;Wu Tingting;Wan Yanfang;Zhang Jun(Department of Cardiology,Central Hospital of Cangzhou City,Cangzhou 061011,China;不详)
出处
《中国循证心血管医学杂志》
2022年第11期1379-1382,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
急性冠脉综合征
匹伐他汀
经皮冠状动脉介入
再灌注损伤
Acute coronary syndrome
Pitavastatin
Percutaneous coronary intervention
Reperfusion injury
