CAJ | 학술논문

目的：观察大剂量阿托伐他汀对急性心肌梗死（ AMI）患者冠状动脉介入治疗（ PCI）术后内皮素－1（ET－1）、一氧化氮（NO）、可溶性细胞间黏附分子－1（slCAM－1）及高敏C－反应蛋白（hs－CRP）、血脂的影响。方法选择2012年9月—2014年9月确诊为AMI并成功行PCI术的患者113例，按数字表法随机分为对照组58例、治疗组55例，2组患者均常规抗凝、抗血小板，逆转心室重构药物，对照组在常规治疗基础上加用阿托伐他汀20 mg口服，治疗组患者在常规治疗基础上加用阿托伐他汀40 mg口服。2组患者均于入院即刻、术后1、30 d时测定外周血NO、ET－1、slCAM－1、hs－CRP水平及血脂水平。观察不同剂量阿托伐他汀对于炎性指标、内皮功能及血脂的影响。结果与治疗前比较，2组治疗30 d ET－1、slCAM－1、hs－CRP及血脂水平降低（ P ＜0．05），NO水平升高（ P ＜0．05）。且治疗30 d时，治疗组较对照组比较变化更为显著（ P ＜0．05）。2组不良反应比较差异无统计学意义（ P ＞0．05）。结论阿托伐他汀可以降低AMI患者PCI术再灌注后炎性反应，改善血管内皮功能，大剂量的阿托伐他汀较常规剂量效应强，且无明显不良反应。
목적：관찰대제량아탁벌타정대급성심기경사（ AMI）환자관상동맥개입치료（ PCI）술후내피소－1（ET－1）、일양화담（NO）、가용성세포간점부분자－1（slCAM－1）급고민C－반응단백（hs－CRP）、혈지적영향。방법선택2012년9월—2014년9월학진위AMI병성공행PCI술적환자113례，안수자표법수궤분위대조조58례、치료조55례，2조환자균상규항응、항혈소판，역전심실중구약물，대조조재상규치료기출상가용아탁벌타정20 mg구복，치료조환자재상규치료기출상가용아탁벌타정40 mg구복。2조환자균우입원즉각、술후1、30 d시측정외주혈NO、ET－1、slCAM－1、hs－CRP수평급혈지수평。관찰불동제량아탁벌타정대우염성지표、내피공능급혈지적영향。결과여치료전비교，2조치료30 d ET－1、slCAM－1、hs－CRP급혈지수평강저（ P ＜0．05），NO수평승고（ P ＜0．05）。차치료30 d시，치료조교대조조비교변화경위현저（ P ＜0．05）。2조불량반응비교차이무통계학의의（ P ＞0．05）。결론아탁벌타정가이강저AMI환자PCI술재관주후염성반응，개선혈관내피공능，대제량적아탁벌타정교상규제량효응강，차무명현불량반응。
Objective To observe the effects of high dose atorvastatin on enodthelin-1 ( ET-1) , nitric oxide ( NO) , soluble intercellular adhesion molecule 1 (slCAM-1) and high sensitive C reactive protein (hs-CRP), blood lipid in acute myocardial infarction ( AMI ) patients with percutnaeous coronary intervention ( PCI ) .Methods From September 2012 to September 2014, 113 patients with AMI after PCI were randomly divided into control group (58 cases) and treatment group (55 cases) , 2 groups were treated with routine anticoagulation, antiplatelet, reverse ventricular remodeling drugs, control group based on the conventional therapy added atorvastatin 20 mg orally, the patients in the treatment group were treated with atorvastatin 40 mg orally on the basis of conventional therapy.2 groups of patients at the immediate and after 1, 30 d admis-sion, peripheral blood NO, ET-1, slCAM-1, hs-CRP level and blood lipid level were determined.Observed the effect of dif-ferent doses of atorvastatin on inflammatory markers, endothelial function and blood lipid.Results Compared with before treatment, after 30 d’ s treatment, ET-1, slCAM-1, hs-CRP and lipid levels were decreased in both of the 2 groups ( P <0.05), level of NO were elevated.And at 30 d’s treatment, these indices in the treatment group were more significant than the control group ( P <0.05).No statistically significant differences of adverse reactions were found in the 2 groups ( P >0.05).Conclusion Atorvastatin can decrease the inflammatory reaction of reperfusion after PCI in AMI patients, improve endothelial function, high dose of atorvastatin has more obvious effect than the conventional dose and no obvious adverse reac-tion were found.