摘要
目的:探究术前应用阿托伐他汀对冠心病(CHD)合并颈动脉狭窄同期介入手术患者预后的影响。方法:选取我院心血管外科2016年2月—2017年7月行冠状动脉旁路移植术(CABG)同期颈动脉内膜剥脱术(CEA)治疗的60例CHD合并颈动脉狭窄患者,以随机数字表法分为研究组和对照组,各30例,对照组术前嚼服肠溶阿司匹林片(300 mg/d)、硫酸氢氯吡格雷片(600 mg/d),研究组加用阿托伐他汀钙片(80 mg/d)。比较两组手术情况、超声心动图指标及血清实验室指标,并至少随访1年,评估预后情况。结果:两组术后颈动脉狭窄处内径、颈动脉狭窄处血液流速、左心室射血分数(LVEF)均较术前改善,且研究组LVEF高于对照组,差异有统计学意义(P<0.05);两组术后血清C反应蛋白(CRP)、肿瘤坏死因子(TNF)-α、基质金属蛋白酶(MMP)-9水平均较术前下降,且研究组低于对照组,差异有统计学意义(P<0.05);研究组不良心脑血管事件(MACCE)发生率低于对照组,差异有统计学意义(P<0.05)。结论:术前应用阿托伐他汀有利于改善CHD合并颈动脉狭窄同期介入手术患者的颈动脉狭窄处血液流速、心功能,减轻炎症反应,促进患者康复。
Objective:To investigate the effect of preoperative application of atorvastatin on the prognosis of patients with coronary heart disease(CHD)complicated with carotid artery stenosis undergoing concurrent interventional surgery.Methods:60 patients with CHD complicated with carotid artery stenosis who underwent coronary artery bypass grafting(CABG)and carotid endarterectomy(CEA)from February 2016 to July 2017 in our hospital were selected and randomly divided into a study group and a control group,30 cases each.The patients in the control group were treated with enteric-coated aspirin chewable tablets(300 mg/d)and clopidogrel hydrogen sulfate tablets(600 mg/d)before surgery,and the patients in the study group were further treated with atorvastatin calcium tablets(80 mg/d).The surgery status,echocardiographic indexes and serum laboratory indexes were compared between the two groups,and the patients were followed up for at least one year.The prognosis was evaluated.Results:The internal diameter of the position with carotid artery stenosis,the blood?ow velocity at the position with carotid artery stenosis and the left ventricular ejection fraction(LVEF)after surgery were better than those before surgery,and the LVEF in the study group was higher than that in the control group,with statistically significant differences(P<0.05).The serum levels of C-reactive protein(CRP),tumor necrosis factor(TNF)-αand matrix metalloproteinase(MMP)-9 after surgery were lower than those before surgery in the two groups,and the levels inthe study group were lower than those in the control group,with statistically significant differences(P<0.05).The incidence of adverse cardiovascular and cerebrovascular events(MACCE)in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Preoperative application of atorvastatin can help to improve blood flow and heart function in the patients with CHD complicated with carotid artery stenosis in the patients undergoing interventional surgery,reduce inflammation and promote rehabilitation.
作者
武子举
郭改平
孙鸿彬
彭旭辉
Wu Zi-ju;Guo Gai-ping;Sun Hong-bin;Peng Xu-hui(Department I of Cardiology,Pingdingshan Second People’s Hospital,Pingdingshan Henan 467000,China)
出处
《中国合理用药探索》
CAS
2019年第11期93-96,共4页
Chinese Journal of Rational Drug Use
关键词
阿托伐他汀
冠心病
颈动脉狭窄
预后
Atorvastatin
Coronary Heart Disease
Carotid Stenosis
Prognosis
作者简介
武子举,男,硕士,主治医师。研究方向:冠心病、心律失常、心力衰竭及高血压病的诊断及治疗。E-mail:wuziju@gmail.com;通讯作者:孙鸿彬,男,主任医师。研究方向:冠心病的介入治疗。E-mail:pdseyxy@163.com
