【摘要】 目的:探讨阿托伐他汀联合经皮冠状动脉介入(PCI)治疗对冠心病合并阵发性心房颤动(房颤)患者的影响。方法:将66例冠心病合并阵发性房颤患者随机分为治疗组(34例)和对照组(32例),采用电话回访及动态心电图检测,对房颤发作次数、持续时间、发作时ST段压低程度进行分析,同时检测治疗前后高敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)、总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白胆固醇(LDL-C)水平,随访6个月以上。在常规治疗的基础上,治疗组采用PCI联合阿托伐他汀治疗,对照组仅采用阿托伐他汀治疗,两组均口服阿托伐他汀,20 mg/次,1次/d。结果:治疗6个月时,两组房颤发作次数、房颤发作持续时间、发作时ST段压低程度明显降低,治疗组上述指标均优于对照组。治疗组hs-CRP、TNF-α、TC、TG及LDL-C水平和对照组hs-CRP、TNF-α水平均较治疗前明显降低,且治疗组hs-CRP和TNF-α降低幅度显著大于对照组;治疗组治疗后hs-CRP、TNF-α、TC、TG及LDL-C水平亦显著低于对照组。结论:阿托伐他汀能有效降低冠心病合并阵发性房颤患者的血脂水平,减轻炎症反应,改善心肌缺血,并减少房颤的发作次数,联合PCI治疗强化了上述疗效。更多还原

【Abstract】 Objective: To investig ate the effects of atorvastatin and percutaneous coronary intervention(PCI) on coronary heart disease(CHD) combined with paroxysmal atrial fibrillation(AF). Methods: A total of 66 CHD patients combined with paroxysmal AF were randomly divided into treatment group(n=34) and control group(n=32). Besides conventional therapy,the treatment group recieved treatment of PCI plus atorvastatin,the control group recieved atorvastatin only. In both groups atorvastatin was givien 20 mg·d-1. Patients were followed up for more than 6 monthsthrough telephone interview and HolterECG to detect the occurred conditions of AF,meanwhile,the levels of hyper-sensitivity C reactive protein(hs-CRP),tumor necrosis factor α(TNF-α),total cholesterol(TC),triglyceride(TG) and low density lipoprotein cholesterol(LDL-C) were detected. Results: After the treatments,the attacks,times of AF and the amplitude of ST segment degrading obviously decreased in these two groups; the levels of hs-CRP,TNF-α,TC,TG and LDL-C in the treatment group as well as the levels of hs-CRP and TNF-α in the control group markedly reduced; and the reduced ranges of hs-CRP and TNF-α in the treatment group were larger than those in the control group; the levels of hs-CRP,TNF-α,TC,TG and LDL-C in the treatment group were significantly lower than those in the control group. Conclusion: Atorvastatin can effectively decrease the levels of blood lipids in CHD patients combined with AF,reduce inflammatory reactions,alleviate myocardial ischemia and reduce AF attacks. Atorvastatin combined with PCI can strengthen all the above-mentioned effects.更多还原