中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2011年
10期
16-19
,共4页
冠状动脉疾病%血管成形术,经腔,经皮冠状动脉%C反应蛋白质%肿瘤坏死因子α%P选择素
冠狀動脈疾病%血管成形術,經腔,經皮冠狀動脈%C反應蛋白質%腫瘤壞死因子α%P選擇素
관상동맥질병%혈관성형술,경강,경피관상동맥%C반응단백질%종류배사인자α%P선택소
Coronary disease%Angioplasty,transluminal,percutaneous coronary%C-reactive protein%Tumor necrosis factor-alpha%P-selectin
目的 观察急性冠脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)前给予阿托伐他汀强化治疗,术后血样高敏C-反应蛋白(hs-CRP)、肿瘤坏死因子(TNF)-α、P-选择素水平的变化,探讨其临床意义.方法 选择择期行PCI的住院患者78例,按随机数字表法分为两组:标准治疗组39例(阿托伐他汀20mg/d),强化治疗组39例(于术前12、2 h分别给予阿托伐他汀40、20mg).检测两组患者术前1 d,术后6、12 h hs-CRP、TNF-α、P-选择素水平,并进行比较.结果 标准治疗组28例、强化治疗组29例成功置入支架.两组术前1 d hs-CRP、TNF-α、P-选择素水平比较差异无统计学意义(P＞0.05),术后6、12 h均较术前显著升高(P＜0.05),标准治疗组术后12 h较术后6 h仍明显增高[hs-CRP:(10.29±0.77)mg/L比(6.34±1.23)mg/L;TNF-α:(58.15±5.19)ng/L比(36.12±3.89)ng/L;P-选择素:(49.58±4.92)μg/L比(31.47±3.71)μg/L](P＜0.05),强化治疗组术后12 h与术后6 h相比虽仍有升高,但差异无统计学意义[hs-CRP:(6.83±1.46)mg/L比(5.95±1.17)mg/L;TNF-α:(42.18±7.79)ng/L比(34.07±8.79)ng/L;P-选择素:(33.57±4.63)μg/I比(29.78±5.61)μg/L](P＞0.05).标准治疗组术后6、12 h hs-CRP、TNF-α、P-选择素水平较强化治疗组增高,但差异无统计学意义(P＞0.05).结论 ACS患者PCI前短期给予阿托伐他汀强化治疗,可有效降低患者hs-CRP、TNF-α、P-选择素水平,有助于PCI后机体促炎和抗炎失衡状态的恢复.
目的 觀察急性冠脈綜閤徵(ACS)患者經皮冠狀動脈介入治療(PCI)前給予阿託伐他汀彊化治療,術後血樣高敏C-反應蛋白(hs-CRP)、腫瘤壞死因子(TNF)-α、P-選擇素水平的變化,探討其臨床意義.方法 選擇擇期行PCI的住院患者78例,按隨機數字錶法分為兩組:標準治療組39例(阿託伐他汀20mg/d),彊化治療組39例(于術前12、2 h分彆給予阿託伐他汀40、20mg).檢測兩組患者術前1 d,術後6、12 h hs-CRP、TNF-α、P-選擇素水平,併進行比較.結果 標準治療組28例、彊化治療組29例成功置入支架.兩組術前1 d hs-CRP、TNF-α、P-選擇素水平比較差異無統計學意義(P＞0.05),術後6、12 h均較術前顯著升高(P＜0.05),標準治療組術後12 h較術後6 h仍明顯增高[hs-CRP:(10.29±0.77)mg/L比(6.34±1.23)mg/L;TNF-α:(58.15±5.19)ng/L比(36.12±3.89)ng/L;P-選擇素:(49.58±4.92)μg/L比(31.47±3.71)μg/L](P＜0.05),彊化治療組術後12 h與術後6 h相比雖仍有升高,但差異無統計學意義[hs-CRP:(6.83±1.46)mg/L比(5.95±1.17)mg/L;TNF-α:(42.18±7.79)ng/L比(34.07±8.79)ng/L;P-選擇素:(33.57±4.63)μg/I比(29.78±5.61)μg/L](P＞0.05).標準治療組術後6、12 h hs-CRP、TNF-α、P-選擇素水平較彊化治療組增高,但差異無統計學意義(P＞0.05).結論 ACS患者PCI前短期給予阿託伐他汀彊化治療,可有效降低患者hs-CRP、TNF-α、P-選擇素水平,有助于PCI後機體促炎和抗炎失衡狀態的恢複.
목적 관찰급성관맥종합정(ACS)환자경피관상동맥개입치료(PCI)전급여아탁벌타정강화치료,술후혈양고민C-반응단백(hs-CRP)、종류배사인자(TNF)-α、P-선택소수평적변화,탐토기림상의의.방법 선택택기행PCI적주원환자78례,안수궤수자표법분위량조:표준치료조39례(아탁벌타정20mg/d),강화치료조39례(우술전12、2 h분별급여아탁벌타정40、20mg).검측량조환자술전1 d,술후6、12 h hs-CRP、TNF-α、P-선택소수평,병진행비교.결과 표준치료조28례、강화치료조29례성공치입지가.량조술전1 d hs-CRP、TNF-α、P-선택소수평비교차이무통계학의의(P＞0.05),술후6、12 h균교술전현저승고(P＜0.05),표준치료조술후12 h교술후6 h잉명현증고[hs-CRP:(10.29±0.77)mg/L비(6.34±1.23)mg/L;TNF-α:(58.15±5.19)ng/L비(36.12±3.89)ng/L;P-선택소:(49.58±4.92)μg/L비(31.47±3.71)μg/L](P＜0.05),강화치료조술후12 h여술후6 h상비수잉유승고,단차이무통계학의의[hs-CRP:(6.83±1.46)mg/L비(5.95±1.17)mg/L;TNF-α:(42.18±7.79)ng/L비(34.07±8.79)ng/L;P-선택소:(33.57±4.63)μg/I비(29.78±5.61)μg/L](P＞0.05).표준치료조술후6、12 h hs-CRP、TNF-α、P-선택소수평교강화치료조증고,단차이무통계학의의(P＞0.05).결론 ACS환자PCI전단기급여아탁벌타정강화치료,가유효강저환자hs-CRP、TNF-α、P-선택소수평,유조우PCI후궤체촉염화항염실형상태적회복.
Objective To observe the changes of postoperative blood high sensitive C-reactive protein (hs-CRP), tumor necrosis factor(TNF)-o, P-selectin levels in patients with acute coronary syndrome (ACS) who had an atorvastatin intensive treatment before operation, and investigate its clinical significance.Methods Seventy-eight cases of ACS patients who intended to undergo percutaneous coronary intervention were divided into two groups by random digits table:39 patients comprising the standard treatment group (given atorvaatatin 20 mg/d, conventional treatment), 39 patients comprising the enhanced group (given atorvastatin 40 mg, 20 mg separately at preoperative 12 h, 2 h on the basis of conventional treatment).Among them, 28 cases of the standard treatment group and 29 cases of the enhanced group finally underwent the test. The hs-CRP,TNF-α ,P-selectin levels at preoperative 1 day,postoperative 6 h,postoperative 12 h were detected and then the changes of three factors were analyzed. Results There was no significant difference in hs-CRP,TNF- α, P-selectin between the two groups at preoperative 1 day. The values of the two groups markedly increased at postoperative 6 h, 12 h and the difference was statistically significant (P ＜0.05). The values of the standard treatment group were markedly higher at postoperative 12 h than those at postoperative 6 h,and the difference was statistically significant [hs-CRP: (10.29 ± 0.77) mg/L vs. (6.34 ±1.23) mg/L;TNF-α: (58.15±5.19) ng/L vs. (36.12 ± 3.89) ng/L;P-selectin: (49.58 ±4.92) μg/L vs.(31.47 ± 3.71) μ g/L] (P ＜ 0.05). However, the values of the enhanced group were higher at postoperative 12 h than those at postoperative 6 h but the difference was no statistically significant [hs-CRP: (6.83 ± 1.46)mg/L vs. (5.95 ± 1.17) mg/L; TNF- o: (42.18 ± 7.79) ng/L vs. (34.07 ± 8.79) ng/L; P-selectin: (33.57 ±4.63) μ g/L vs. (29.78 ± 5.61) μ g/L] (P ＞ 0.05). Three factors in standard treatment group were elevating significantly at postoperative 6 h, 12 h compared with those in the enhanced group, but the difference was no statistically significant (P ＞ 0.05). Conclusion Short-term intensive therapy of atorvastatin in ACS patients who intend to do PCI, can reduce the hs-CRP, TNF-α, P-selectin levels effectively.
