CAJ | 학술논문

目的研究普伐他汀对常规体外循环冠状动脉旁路移植术(CCABG)患者血脂和高敏C反应蛋白(HsCRP)水平的影响.方法分析比较40例口服普伐他汀(20 mg,每日 1次),与41例冠状动脉旁路移植术(CABG)患者(对照组,不给予普伐他汀),术后不同时间血浆总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和HsCRP水平.结果对照组术后24 h血脂(TC、TG、HDL-C、LDL-C)均明显下降分别为(2.6±0.7)mmol/L,(0.56±0.26)mmol/L,(0.92 ±0.26)mmol/L,(1.4 ±0.5)mmol/L(P＜0.05),以后不同时段逐渐升高但仍明显低于术前(P＜0.05),28 d恢复基线水平(P＞0.05);普伐他汀组术后24 h血脂(TC、TG、LDLC)明显下降分别为(2.2±0.5)mmol/L,(0.70±0.23)mmol/L,(1.2±0.6)mmol/L(P＜0.05),TC以后各时段逐渐升高但仍低于术前(P＜0.05),28 d恢复基线水平(P＞0.05),HDL手术前后变化差异无统计学意义(P＞0.05).两组间比较,普伐他汀组TC、TG、LDL-C术后7、10、14、28 d水平低于对照组(P＜0.05).两组HsCRP均术后24 h升高,72 h达峰值,以后逐渐降低,对照组第10天后变化差异无统计学意义[(18 ±14)g/L,P＞0.05],28 d恢复基线水平;普伐他汀组第7天后变化差异无统计学意义[(12±10)g/L,P＞0.05],14 d恢复基线水平.两组间比较,普伐他汀组HsCRP术后各时间段水平均低于对照组(P＜0.05).结论 CCABG术后早期普伐他汀调脂治疗是安全的且能减轻术后体内炎症反应过程.
목적 연구보벌타정대상규체외순배관상동맥방로이식술(CCABG)환자혈지화고민C반응단백(HsCRP)수평적영향.방법 분석비교40례구복보벌타정(20 mg,매일 1차),여41례관상동맥방로이식술(CABG)환자(대조조,불급여보벌타정),술후불동시간혈장총담고순(TC)、감유삼지(TG)、고밀도지단백담고순(HDL-C)、저밀도지단백담고순(LDL-C)화HsCRP수평.결과 대조조술후24 h혈지(TC、TG、HDL-C、LDL-C)균명현하강분별위(2.6±0.7)mmol/L,(0.56±0.26)mmol/L,(0.92 ±0.26)mmol/L,(1.4 ±0.5)mmol/L(P＜0.05),이후불동시단축점승고단잉명현저우술전(P＜0.05),28 d회복기선수평(P＞0.05);보벌타정조술후24 h혈지(TC、TG、LDLC)명현하강분별위(2.2±0.5)mmol/L,(0.70±0.23)mmol/L,(1.2±0.6)mmol/L(P＜0.05),TC이후각시단축점승고단잉저우술전(P＜0.05),28 d회복기선수평(P＞0.05),HDL수술전후변화차이무통계학의의(P＞0.05).량조간비교,보벌타정조TC、TG、LDL-C술후7、10、14、28 d수평저우대조조(P＜0.05).량조HsCRP균술후24 h승고,72 h체봉치,이후축점강저,대조조제10천후변화차이무통계학의의[(18 ±14)g/L,P＞0.05],28 d회복기선수평;보벌타정조제7천후변화차이무통계학의의[(12±10)g/L,P＞0.05],14 d회복기선수평.량조간비교,보벌타정조HsCRP술후각시간단수평균저우대조조(P＜0.05).결론 CCABG술후조기보벌타정조지치료시안전적차능감경술후체내염증반응과정.
Objective To investigate the effect of pravastatin on blood lipids and serum high sensitive C-reactive protein(HsCRP)in patients undergoing conventional coronary artery bypass grafting under on-pump bypass(CCABG).Methods Eighty-one patients underwent CCABG.Among which 40 took orally pravastatin 20 mg once daily to at least 28 days after operation,and 41 were used as control group.The serum levels of total cholesterol(TC),triglyceride(TG),HDL-C cholesterol(HDL-C),LDI-C cholesterol(LDL-C),and HsCRP were monitored before and 24 h,72 h,7 days,10 days,14 days,and 28 days postoperatively.Results In the control group the levels of different blood lipids after operation remarkably decreased after operation compared with those before operation(all P＜0.05),reached the lowest levels 24 h after operation,then gradually increased,however,still lower than those before operation (all P＜0.05),and recovered to the baseline level 28 hours after operation;and the HsCRP level increased 24 h after operation and peaked 72 h after,then gradually decreased,and recovered to the baseline level 28 days after operation.In the pravastatin group the TC level reached its lowest level 24 h after operation,then graduallv increased,however,still lower than that before operation,and recovered to the baseline level 28 days after operation;and the TG level reached the lowest level 24 h after operation(P＜0.05),and then gradually increased 3 d after operation(P＞0.05).The TC,TG,and LDL-C levels 7,10,14,and 28 d after operation of the pravastatin group were all significantly lower than those of the control group(all P＜0.05).The HsCRP levels at different time points of the pravastatin group were all significantly lower than those of the control group(all P＜0.05).Conclusion The use of pravastatin in the early stage of CCABG is safe and can decrease systemic inflammatory reaction.