天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (3): 285-287.doi: 10.11958/j.issn.0253-9896.2015.03.017

• 专题研究·心血管疾病 • 上一篇    下一篇

围术期强化阿托伐他汀治疗对 AMI 患者急诊 PCI 术后 Lp-PLA2及炎症因子的影响

单瑞 1， 吴尚勤 2， 程爱娟 2△#br# #br#   

  1. 1 天津医科大学研究生院(邮编 300070)； 2 天津市胸科医院心内六病区
  • 收稿日期:2014-04-15 修回日期:2014-09-23 出版日期:2015-03-15 发布日期:2015-03-15
  • 通讯作者: 程爱娟 E-mail:ytcaj@sina.com
  • 作者简介:单瑞 （1988）， 男， 硕士， 主要从事心血管疾病基础及临床研究
  • 基金资助:
    天津市卫生行业重点攻关项目(12KG126)； 天津市卫生局科技基金(2011KZ61)

Effects of loading dose of atorvastatin on inflammatory cytokines in acute myocardial infarction patients undergoing emergency percutaneous coronary intervention

SHAN Rui1, WU Shangqin2, CHENG Aijuan2△   

  1. 1Graduate School of Tianjin Medical University, Tianjin 300070, China; 2 Department of Cardiology, Tianjin Chest Hospital
  • Received:2014-04-15 Revised:2014-09-23 Published:2015-03-15 Online:2015-03-15
  • Contact: CHENG Aijuan E-mail:ytcaj@sina.com

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摘要： 目的 探讨围术期强化阿托伐他汀治疗对急性心肌梗死（AMI）患者急诊经皮冠状动脉介入治疗（PCI）术后脂蛋白相关磷脂酶 A（ 2 Lp-PLA2） 及炎症因子的影响。方法 选择因 AMI 行急诊 PCI 的患者 65 例， 其中男 32 例，女 33 例， 平均年龄 （70.62±6.49） 岁。按随机数字表法分为 2 组， 标准组 32 例： 术前顿服阿托伐他汀 20 mg， 术后继续予阿托伐他汀 20 mg/24 h 口服； 强化组 33 例： 术前顿服阿托伐他汀 40 mg， 术后继续予阿托伐他汀 40 mg/24 h 口服。所有患者分别于治疗前和 PCI 术后 72 h 抽取空腹肘正中静脉血， 检测 Lp-PLA2、 白细胞介素（IL） -6、 肿瘤坏死因子（TNF） -α、 丙氨酸转氨酶（ALT）及天冬氨酸转氨酶（AST）水平。结果 标准组与强化组治疗前血清 Lp-PLA2、 IL-6、 TNF-α、 ALT 及 AST 基线水平差异无统计学意义（P＞0.05）； 2 组患者 PCI 术后 Lp-PLA2、 IL-6 及 TNF-α水平较术前均升高， 且标准组较强化组升高更明显（均 P＜0.05）； ALT 及 AST 较术前升高（P＜0.05）， 但 2 组 PCI 术后差异无统计学意义（P＞0.05）。结论 围术期强化阿托伐他汀治疗更能显著减轻 AMI 患者急诊 PCI 术后急性期机体炎症反应， 稳定斑块， 且具有良好的安全性。

关键词: 斯伐他汀； 心肌梗死； 血管成形术, 经腔, 经皮冠状动脉； 磷脂酶 A2； 阿托伐他汀

Abstract: Objective To investigate the effects of high loading dose of atorvastatin on lipoprotein-associated phospho⁃ lipase A2 (Lp-PLA2) and inflammatory cytokines in patients with acute myocardial infarction (AMI), who underwent emergen⁃ cy percutaneous coronary intervention (PCI). Methods A total of 65 cases with AMI who underwent emergency PCI be⁃ tween October 2011 and August 2013 were randomly divided into two groups: control group (n=32, atorvastatin 20 mg/24 h) and high dose atorvastatin group (n=33, atorvastatin 40 mg/24 h). Two groups of patients were given the same basic treat⁃ ment. Blood samples were obtained before treatment and 72 h after PCI in two groups. Levels of Lp-PLA2, interleukin-6 (IL- 6), tumor necrosis factor- α (TNF-α), alanine transaminase (ALT) and aspartate transaminase (AST) were detected in two groups. The adverse drug reactions were observed. Results There were no significant differences in Lp-PLA2, IL-6, TNF- α, ALT and AST levels between two groups (P＞0.05). After PCI, the levels of Lp-PLA2, IL-6 and TNF-α were significantly increased compared with those of baseline in two groups, and they were more notable in control group than those of high dose atorvastatin group (P＜0.05). The levels of ALT and AST were also significantly higher after operation compared with those of basic levels (P＜0.05), while there were no significant differences in ALT and AST after PCI between two groups (P＞0.05). Conclusion The high loading dose of atorvastatin in AMI patients underwent emergency PCI can de⁃ crease the inflammation and stabilize the plaques in acute stage, and which is safe.

Key words: simvastatin, myocardial infarction, angioplasty, transluminal, percutaneous coronary, phospholipases A2, Atorvastatin