CAJ | 학술논문

目的：探讨不同剂量阿托伐他汀对经皮冠状动脉介入（PCI）治疗后血脂和心血管事件的影响。方法选择2012年6月~2014年1月于延安大学咸阳医院心内科收治的不稳定型心绞痛（unstable angina，UA）患者120例。随机分为两组，40 mg组62例，其中男性32例，女性30例，平均年龄（52.10±10.55）岁；20 mg组58例，其中男性30例，女性28例，平均年龄（51.09±9.54）岁。分别于PCI治疗前给予阿托伐他汀20 mg和40 mg，PCI治疗后继续服用阿托伐他汀。比较两组患者治疗前、治疗后1个月、6个月总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、三酰甘油（TG）及高密度脂蛋白胆固醇（HDL-C）水平、主要不良心血管事件及不良反应的发生情况。结果与本组术前比较，两组PCI术后1个月、6个月TC、LDL-C、TG降低，差异有统计学意义（P均＜0.05）。与20 mg组比较，40 mg组PCI术后6个月TC，术后1个月及6个月LDL-C、TG降低，差异有统计学意义（P均＜0.05）。PCI后6个月内40 mg组主要不良心血管事件发生率为8.1%，20 mg组为13.8%，两组差异有统计学意义（P＜0.05）。40 mg组出现肝功能异常2例，20 mg组1例，未出现横纹肌溶解等不良反应，两组不良反应发生率差异无统计学意义（P＞0.05）。结论阿托伐他汀降低经皮冠状动脉介入术后患者血脂，但使用40 mg患者较20 mg术后主要不良心血管事件减少。
목적：탐토불동제량아탁벌타정대경피관상동맥개입（PCI）치료후혈지화심혈관사건적영향。방법선택2012년6월~2014년1월우연안대학함양의원심내과수치적불은정형심교통（unstable angina，UA）환자120례。수궤분위량조，40 mg조62례，기중남성32례，녀성30례，평균년령（52.10±10.55）세；20 mg조58례，기중남성30례，녀성28례，평균년령（51.09±9.54）세。분별우PCI치료전급여아탁벌타정20 mg화40 mg，PCI치료후계속복용아탁벌타정。비교량조환자치료전、치료후1개월、6개월총담고순（TC）、저밀도지단백담고순（LDL-C）、삼선감유（TG）급고밀도지단백담고순（HDL-C）수평、주요불양심혈관사건급불량반응적발생정황。결과여본조술전비교，량조PCI술후1개월、6개월TC、LDL-C、TG강저，차이유통계학의의（P균＜0.05）。여20 mg조비교，40 mg조PCI술후6개월TC，술후1개월급6개월LDL-C、TG강저，차이유통계학의의（P균＜0.05）。PCI후6개월내40 mg조주요불양심혈관사건발생솔위8.1%，20 mg조위13.8%，량조차이유통계학의의（P＜0.05）。40 mg조출현간공능이상2례，20 mg조1례，미출현횡문기용해등불량반응，량조불량반응발생솔차이무통계학의의（P＞0.05）。결론아탁벌타정강저경피관상동맥개입술후환자혈지，단사용40 mg환자교20 mg술후주요불양심혈관사건감소。
Objective To investigate the influence of atorvastatin in different doses on blood fat and major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI).Methods The patients with unstable angina pectoris (UAP) were chosen (n=120) from Jun. 2012 to Jan. 2014, and randomly divided into 40-mg group (n=62, male 32, female 30 and average age=52.10±10.55) treated with 40 mg atorvastatin and 20-mg group (n=58, male 30, female 28 and average age=51.09±9.54) treated with 20 mg atorvastatin before PCI, and continuously given atorvastatin after PCI. The levels of TC, LDL-C, TG and HDL-C, and incidence of MACE and adverse reactions were compared in 2 groups before, 1 m and 6 m after treatment.Results The levels of TC, LDL-C and TG decreased in 2 groups 1 m and 6 m after PCI (allP<0.05). The level of TC decreased 6 m after PCI, and levels of LDL-C and TG decreased 1 m and 6 m after PCI in 40-mg group compared with 20-mg group (allP<0.05). The incidence of MACE was 8.1% in 40-mg group and 13.8% in 20-mg group within 6 m after PCI (P<0.05). There were 2 patients with abnormal liver function in 40-mg group and 1 in 20-mg group, and there was no case of rhabdomyolysis or other adverse reactions observed in 2 group (P>0.05).Conclusion Atorvastatin can reduce the level of blood fat in UAP patients after PCI, and the incidence of MACE decreases in patients with 40 mg atorvastatin than that in those with 20 mg atorvastatin.