中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
34期
8-11
,共4页
徐峰%徐海涛%杨学成%程璐%刘金尧
徐峰%徐海濤%楊學成%程璐%劉金堯
서봉%서해도%양학성%정로%류금요
冠状动脉疾病%P选择素%C反应蛋白质%经皮冠状动脉介入术%阿托伐他汀
冠狀動脈疾病%P選擇素%C反應蛋白質%經皮冠狀動脈介入術%阿託伐他汀
관상동맥질병%P선택소%C반응단백질%경피관상동맥개입술%아탁벌타정
Coronary disease%P-selectin%C-reactive protein%Percutaneous coronary intervention%Atorvastatin
目的 观察阿托伐他汀强化治疗对经皮冠状动脉介入术(PCI)后可溶性P-选择素(sP-selectin)和高敏C反应蛋白(hs-CRP)水平的影响,探讨阿托伐他汀强化治疗在PCI术后心肌保护方面的作用.方法 选取PCI治疗的冠心病患者100例,按随机数字表法分为三组:标准治疗组(A组,阿托伐他汀20 mg) 30例、低剂量阿托伐他汀强化治疗组(B组,术前12、2h阿托伐他汀分别追加40、20 mg) 35例、高剂量阿托伐他汀强化治疗组(C组,术前12、2h阿托伐他汀分别追加80、40mg) 35例；采用酶联免疫吸附试验法检测血浆sP-selectin水平,乳胶增强免疫比浊法检测血清hs-CRP水平.结果 血浆sP-selectin水平A、B、C组术前分别为(2.32±0.40)、(2.51±0.33)、(2.47±0.28) μg/L,术后6h分别为(4.12±0.75)、(3.34±0.42)、(3.31±0.46) μg/L,术后12h分别为(5.64±1.07)、(4.08±0.74)、(3.84±0.48) μg/L,血浆sP-selectin水平在PCI术后各时间点均较术前显著升高,差异有统计学意义(P＜0.05)；术后相同时间点B、C组血浆sP-selectin水平均显著低于A组,差异有统计学意义(P＜0.05).血清hs-CRP水平A、B、C组术前分别为(4.32±0.51)、(4.46±0.57)、(4.29±0.43) mg/L,术后6h分别为(8.91±1.34)、(7.44±1.06)、(7.28±0.95) mg/L,术后12h分别为(13.66±1.49)、(8.08±1.14)、(7.92±1.04) mg/L,血清hs-CRP水平在PCI术后各时间点均较术前显著升高,差异有统计学意义(P＜0.05)；相同时间点B、C组血清hs-CRP水平均显著低于A组,差异有统计学意义(P＜0.05).Pearson相关性分析结果显示,sP-selectin与hs-CRP的表达水平呈正相关(r=0.753,P＜0.01).PCI术后围手术期A、B、C组心肌梗死再发生率分别为23.3％(7/30)、5.7％(2/35)、2.9％(1/35),B组与C组比较差异无统计学意义(P＞0.05),A组与B、C组比较差异有统计学意义(P＜0.05).结论 阿托伐他汀强化治疗可以抑制PCI术后炎性因子sP-selectin和hs-CRP的表达水平,阿托伐他汀强化治疗可以显著降低PCI术后心血管不良事件的发生率,对心肌具有一定的保护作用.
目的 觀察阿託伐他汀彊化治療對經皮冠狀動脈介入術(PCI)後可溶性P-選擇素(sP-selectin)和高敏C反應蛋白(hs-CRP)水平的影響,探討阿託伐他汀彊化治療在PCI術後心肌保護方麵的作用.方法 選取PCI治療的冠心病患者100例,按隨機數字錶法分為三組:標準治療組(A組,阿託伐他汀20 mg) 30例、低劑量阿託伐他汀彊化治療組(B組,術前12、2h阿託伐他汀分彆追加40、20 mg) 35例、高劑量阿託伐他汀彊化治療組(C組,術前12、2h阿託伐他汀分彆追加80、40mg) 35例；採用酶聯免疫吸附試驗法檢測血漿sP-selectin水平,乳膠增彊免疫比濁法檢測血清hs-CRP水平.結果 血漿sP-selectin水平A、B、C組術前分彆為(2.32±0.40)、(2.51±0.33)、(2.47±0.28) μg/L,術後6h分彆為(4.12±0.75)、(3.34±0.42)、(3.31±0.46) μg/L,術後12h分彆為(5.64±1.07)、(4.08±0.74)、(3.84±0.48) μg/L,血漿sP-selectin水平在PCI術後各時間點均較術前顯著升高,差異有統計學意義(P＜0.05)；術後相同時間點B、C組血漿sP-selectin水平均顯著低于A組,差異有統計學意義(P＜0.05).血清hs-CRP水平A、B、C組術前分彆為(4.32±0.51)、(4.46±0.57)、(4.29±0.43) mg/L,術後6h分彆為(8.91±1.34)、(7.44±1.06)、(7.28±0.95) mg/L,術後12h分彆為(13.66±1.49)、(8.08±1.14)、(7.92±1.04) mg/L,血清hs-CRP水平在PCI術後各時間點均較術前顯著升高,差異有統計學意義(P＜0.05)；相同時間點B、C組血清hs-CRP水平均顯著低于A組,差異有統計學意義(P＜0.05).Pearson相關性分析結果顯示,sP-selectin與hs-CRP的錶達水平呈正相關(r=0.753,P＜0.01).PCI術後圍手術期A、B、C組心肌梗死再髮生率分彆為23.3％(7/30)、5.7％(2/35)、2.9％(1/35),B組與C組比較差異無統計學意義(P＞0.05),A組與B、C組比較差異有統計學意義(P＜0.05).結論 阿託伐他汀彊化治療可以抑製PCI術後炎性因子sP-selectin和hs-CRP的錶達水平,阿託伐他汀彊化治療可以顯著降低PCI術後心血管不良事件的髮生率,對心肌具有一定的保護作用.
목적 관찰아탁벌타정강화치료대경피관상동맥개입술(PCI)후가용성P-선택소(sP-selectin)화고민C반응단백(hs-CRP)수평적영향,탐토아탁벌타정강화치료재PCI술후심기보호방면적작용.방법 선취PCI치료적관심병환자100례,안수궤수자표법분위삼조:표준치료조(A조,아탁벌타정20 mg) 30례、저제량아탁벌타정강화치료조(B조,술전12、2h아탁벌타정분별추가40、20 mg) 35례、고제량아탁벌타정강화치료조(C조,술전12、2h아탁벌타정분별추가80、40mg) 35례；채용매련면역흡부시험법검측혈장sP-selectin수평,유효증강면역비탁법검측혈청hs-CRP수평.결과 혈장sP-selectin수평A、B、C조술전분별위(2.32±0.40)、(2.51±0.33)、(2.47±0.28) μg/L,술후6h분별위(4.12±0.75)、(3.34±0.42)、(3.31±0.46) μg/L,술후12h분별위(5.64±1.07)、(4.08±0.74)、(3.84±0.48) μg/L,혈장sP-selectin수평재PCI술후각시간점균교술전현저승고,차이유통계학의의(P＜0.05)；술후상동시간점B、C조혈장sP-selectin수평균현저저우A조,차이유통계학의의(P＜0.05).혈청hs-CRP수평A、B、C조술전분별위(4.32±0.51)、(4.46±0.57)、(4.29±0.43) mg/L,술후6h분별위(8.91±1.34)、(7.44±1.06)、(7.28±0.95) mg/L,술후12h분별위(13.66±1.49)、(8.08±1.14)、(7.92±1.04) mg/L,혈청hs-CRP수평재PCI술후각시간점균교술전현저승고,차이유통계학의의(P＜0.05)；상동시간점B、C조혈청hs-CRP수평균현저저우A조,차이유통계학의의(P＜0.05).Pearson상관성분석결과현시,sP-selectin여hs-CRP적표체수평정정상관(r=0.753,P＜0.01).PCI술후위수술기A、B、C조심기경사재발생솔분별위23.3％(7/30)、5.7％(2/35)、2.9％(1/35),B조여C조비교차이무통계학의의(P＞0.05),A조여B、C조비교차이유통계학의의(P＜0.05).결론 아탁벌타정강화치료가이억제PCI술후염성인자sP-selectin화hs-CRP적표체수평,아탁벌타정강화치료가이현저강저PCI술후심혈관불량사건적발생솔,대심기구유일정적보호작용.
Objective To investigate the effect of atorvastatin on the expressions of solubility P-selectin(sP-selectin) and high sensitive C reactive protein(hs-CRP) in patients with percutaneous coronary intervention (PCI),and to explore the protective effect of atorvastatin on myocardium.Methods A total of 100 acute coronary syndrome patients having underwent successful PCI were enrolled in this study.All patients were divided into 3 groups by random digits table method:standard treatment group (group A,30 patients,atorvastatin 20 mg),low-dose atorvastatin pretreatment group (group B,35 patients,preoperative 12 h and 2 h atorvastatin 40 mg and 20 mg,respectively) and high-dose atorvastatin pretreatment group (group C,35 patients,preoperative 12 h and 2 h atorvastatin 80 mg and 40 mg,respectively).The level of sP-selectin was measured with ELISA.The level of hs-CRP was measured with latex enhanced immunoturbidimetry.Results Before operation,the levels of sP-selectin in group A,B,C were (2.32 ±0.40),(2.51 ± 0.33),(2.47 ± 0.28) μ g/L.After 6 and 12 h of operation,the levels of sP-selectin in group A,B,C were (4.12 ± 0.75),(3.34 ± 0.42),(3.31 ± 0.46) μ g/L and (5.64 ± 1.07),(4.08 ± 0.74),(3.84 ±0.48) μg/L.The levels of sP-selectin in group A,B,C after operation were significantly higher than that before operation (P ＜ 0.05).At the same time point,the levels of sP-selectin in group B,C after operation were significantly lower than that in group A (P＜ 0.05).Before operation,the levels of hs-CRP in group A,B,C were (4.32 ±0.51),(4.46 ±0.57),(4.29 ±0.43) mg/L,after 6 and 12 h of operation,the levels of hs-CRP in group A,B,C were (8.91 ± 1.34),(7.44 ± 1.06),(7.28 ±0.95) mg/L and (13.66 ± 1.49),(8.08 ± 1.14),(7.92 ± 1.04) mg/L.The levels of hs-CRP in group A,B,C after operation were significantly higher than that before operation (P＜ 0.05).At the same time point,the levels of hs-CRP in group B,C after operation were significantly lower than that in group A (P ＜ 0.05).The analysis of Pearson correlation showed,the level of sP-selectin was positively related with hs-CRP (r =0.753,P ＜0.01).The incidence of perioperative myocardial infarction was 23.3％ (7/30),5.7％ (2/35) and 2.9％ (1/35) in group A,B and C,respectively.The incidence in group A was significantly higher than that in group B and C (P ＜ 0.05).But there was no significant difference between group B and group C (P＞ 0.05).Conclusion The atorvastatin pretreatment can decrease the levels of sP-selectin and hs-CRP in patients after PCI,which play an important role in myocardium protection.
