【摘要】 目的通过观察血清高敏C反应蛋白(hs-CRP)、可溶性CD40L(sCD40L)等指标变化,探讨在急性心肌梗死(AMI)急诊经皮冠状动脉介入治疗(PCI)围术期他汀类药物强化治疗的效果及意义。方法将112例行急诊PCI治疗的AMI患者随机分为治疗1组40例(术前服阿托伐他汀80mg,术后服阿托伐他汀40mgqd)、治疗2组40例(术前服阿托伐他汀40mg,术后服阿托伐他汀20mgqd)和对照组32例(常规治疗),3组基线资料具有可比性。分别测定3组PCI术后血清hs-CRP、sCD40L及肌酸激酶同工酶(CK-MB)水平。结果与对照组比较,治疗1组和治疗2组PCI治疗后12h、24h、7d血清hs-CRP、sCD40L水平均明显下降(P均<0.01),治疗1组和治疗2组之间差异有统计学意义(P均<0.01)。2个治疗组术后12、24h的CK-MB升高>2倍正常值上限的患者发生率均较对照组明显降低(P均<0.05),2个治疗组比较差异亦有统计学意义(P均<0.05)。结论 AMI患者急诊PCI围术期强化他汀类药物治疗,可能通过抗炎、抗血小板、稳定冠脉血管内皮及粥样斑块等作用,使患者获益。更多还原

【Abstract】 Objective To investigate the clinical effects and significance of intensive statins drugs therapy on soluble CD40L(sCD40L) and high-sensitive C-reactive protein (hs-CRP) in AMI patients during perioperative period of emergency percutaneous coronary intervention(PCI).Methods A total of 112 AMI patients underwent PCI were randomly divided into three groups:the control group(n=32) was given routine medicine,and the treatment group 1 and 2(n=40 each) were respectively administered atorvastatin 80 or 40 mg before PCI,and then were respectively administered atorvastatin 40 or 20 mg qd after PCI.The baseline data were comparable in 3 groups.Levels of hs-CRP,sCD40L and creatine kinase-MB(CK-MB)were determined and compared after PCI.Results Compared with the control group,the levels of serum hs-CRP and sCD40L 12 h,24 h and 7 days after PCI and the ratio of the patients with the elevation of CK-MB two times more than the cutoff value 12 and 24 h after PCI were significantly decreased in treatment group 1 and 2(P<0<01 or P<0<05),and there were significant differences between the two treatment groups (all P<0<05). Conclusions Intensive treatment of atorvastatin in AMI patients during perioperative period of PCI is more beneficial,and its mechanism is possibly correlated with anti-inflammatory,anti-platelets,stabilizing atheromatous plaque and coronary vascular endothelial function.更多还原