CAJ | 학술논문

目的：观察急性冠脉综合征（ACS ）行PCI患者使用阿托伐他汀序贯治疗6个月的疗效以及安全性。方法：连续入选280例ACS患者，随机均分为序贯治疗组（术前2d给予阿托伐他汀80mg ，术后给予40mg／d ，1月后改为20mg／d）及常规治疗组（术前未服用阿托伐他汀，术后及维持量均予20mg／d），观察6个月，比较两组患者的疗效及安全性。结果：两组术后18h～24h肌酸激酶同工酶（CK‐MB）、心肌肌钙蛋白I （cTnI）水平均明显高于治疗前，序贯治疗组的水平明显低于常规治疗组[CK‐MB ：（2.72±0.52）μg／L 比（6.04±0.51）μg／L ，cTnI ：（0.28±0.13）μg／L比（0.42±0.16）μg／L ， P均＜0.01]；术后2d ，序贯治疗组高敏C反应蛋白（hsCRP）水平即显著低于常规治疗组，一直维持到术后6月[（1.49±0.78） mg／L比（2.34±0.51） mg／L ， P＝0.001]，序贯治疗组血脂水平（除高密度脂蛋白水平显著升高外）较常规治疗组显著降低（ P均＜0.01）；两组转氨酶大于3倍以上比例、主要不良心血管事件（MACE）发生率无明显差异（P均＞0.05）。结论：急性冠脉综合征患者PCI术前80mg阿托伐他汀联合术后40mg阿托伐他汀治疗，可明显降低炎症反应，改善血脂；与常规剂量比较，未明显增加药物不良反应，安全有效。
목적：관찰급성관맥종합정（ACS ）행PCI환자사용아탁벌타정서관치료6개월적료효이급안전성。방법：련속입선280례ACS환자，수궤균분위서관치료조（술전2d급여아탁벌타정80mg ，술후급여40mg／d ，1월후개위20mg／d）급상규치료조（술전미복용아탁벌타정，술후급유지량균여20mg／d），관찰6개월，비교량조환자적료효급안전성。결과：량조술후18h～24h기산격매동공매（CK‐MB）、심기기개단백I （cTnI）수평균명현고우치료전，서관치료조적수평명현저우상규치료조[CK‐MB ：（2.72±0.52）μg／L 비（6.04±0.51）μg／L ，cTnI ：（0.28±0.13）μg／L비（0.42±0.16）μg／L ， P균＜0.01]；술후2d ，서관치료조고민C반응단백（hsCRP）수평즉현저저우상규치료조，일직유지도술후6월[（1.49±0.78） mg／L비（2.34±0.51） mg／L ， P＝0.001]，서관치료조혈지수평（제고밀도지단백수평현저승고외）교상규치료조현저강저（ P균＜0.01）；량조전안매대우3배이상비례、주요불양심혈관사건（MACE）발생솔무명현차이（P균＞0.05）。결론：급성관맥종합정환자PCI술전80mg아탁벌타정연합술후40mg아탁벌타정치료，가명현강저염증반응，개선혈지；여상규제량비교，미명현증가약물불량반응，안전유효。
Objective:To observe therapeutic effect and safety of six‐month atrovastatin sequential treatment on pa‐tients with acute coronary syndrome (ACS) undergoing PCI .Methods :A total of 280 ACS patients were consecu‐tively enrolled ,randomly and equally divided into sequential treatment group (received atorvastatin 80mg 2d before PCI operation ,then 40mg/d after operation ,20mg/d a month later ) and routine treatment group (no taking atorv‐astatin before PCI operation ,then 20mg/d after operation and as a maintenance dose ) .Both groups were observed for six months ,therapeutic effect and safety were compared between two groups .Results:Compared with before PCI ,there were significant rise in levels of creatine kinase isoenzyme (CK‐MB) and cardiac troponin I (cTnI) after PCI 18h~24h in two groups ,and those of sequential treatment group were significantly lower than those in routine treatment group [CK‐MB:(2.72 ± 0.52) μg/L vs .(6.04 ± 0.51) μg/L ,cTnI : (0.28 ± 0.13) μg/L vs .(0.42 ± 0.16) μg/L , P < 0.01 both ];Compared with routine treatment group , the high sensitive C reactive protein (hsCRP) level significantly reduced in sequential treatment group after PCI 2d ,and continued until post‐operation six months [ (2.34 ± 0.51) mg/L vs .(1.49 ± 0.78) mg/L ,P=0.001];the blood lipids levels (except level of high density lipoprotein cholesterol significantly rose ) in sequential treatment group were significant lower than those of routine treatment group , P<0.01 all;there were no significant difference in percentage of transaminase level high‐er than normal three times and incidence rates of major adverse cardiovascular events (MACE) between two groups , P>0.05 all .Conclusion:Preoperative 80mg atrovastatin combined postoperative 40mg atrovastatin treatment can significantly reduce inflammatory reaction ,improve blood lipids ;compared with routine dose ,it doesn't significant‐ly increase adverse drug reactions ,so it's safe and effective .