蒋羽+毕卉

[摘要]目的 探討不同剂量阿托伐他汀对冠心病介入术后患者心功能、血脂指标的影响及安全性。方法 选取2015年1～12月我院收治的100例行经皮冠状动脉介入术治疗的冠心病患者，采用随机数字表法分为常规剂量组和大剂量组，各50例。两组患者术后均给予阿托伐他汀治疗，常规剂量组：20 mg/（次·d），大剂量组：40 mg/（次·d），均连续用药1个月。比较两组患者的心功能、血脂指标及用药安全性。结果 治疗前，两组患者的各项心功能指标差异无统计学意义（P>0.05），治疗后，大剂量组患者的左室收缩末期容积指数（LVESVI）、左室舒张末期容积指数（LVEDVI）显著低于常规剂量组，左室射血分数（LVEF）显著高于常规剂量组，差异均有统计学意义（P<0.05）。治疗前，两组患者的各项血脂指标差异无统计学意义（P>0.05），治疗后，大剂量组患者的总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）显著低于常规剂量组，差异有统计学意义（P<0.05）。大剂量组患者出现头晕1例，消化道反应2例，尿素氮升高1例，总不良反应发生率为8.0%，常规剂量组患者出现头晕1例，消化道反应1例，尿素氮升高1例，总不良反应发生率为6.0%，两组的总不良反应发生率差异无统计学意义（P>0.05）。结论 冠心病患者介入术后应用阿托伐他汀可有效改善心功能及血脂指标，大剂量应用的疗效更佳，且安全性较好，值得临床推广应用。

[关键词]冠心病；介入手术；阿托伐他汀；剂量；心功能；血脂

[中图分类号] R541.4 [文献标识码] A [文章编号] 1674-4721（2017）01（c）-0104-03

[Abstract]Objective To study the effect of different doses of Atorvastatin on cardiac function and blood lipid index in patients with coronary artery disease （CAD） after coronary intervention as well as their safety.Methods 100 patients with CAD undergone percutaneous coronary intervention （PCI） in our hospital from January to December 2015 were selected as research objects.By a random number table method，they were randomly divided into conventional （n=50） and high-dose group （n=50）.After surgery，they were both provided with Atorvastatin at a dose of 20 mg once per day （conventional dose group） and 40 mg once per day （high dose group）.The course of treatment was lasted for one month.The cardiac function，blood lipid and drug safety between the two groups were compared.Results Before treatment，there was no difference in each index of cardiac function between the two groups （P>0.05）.After therapy，the left ventricular end systolic volume index （LVESVI） and left ventricular end diastolic volume index （LVEDVI） in the high dose group were both significantly lower than those in the conventional dose group，the left ventricular ejection fraction （LVEF） was higher in comparison with that in the conventional dose group，which were all displayed statistical difference （P<0.05）.No difference was found in each index of blood lipid before treatment in both groups （P>0.05）.After PCI，the total cholesterol （TC） and low density lipoprotein cholesterol （LDL-C） were both obviously lower than those in the conventional dose group with statistical difference （P<0.05）.With regards to adverse reactions，there were vertigo in one case，digestive tract reaction in two cases，and increase of urea nitrogen in one case in the high dose group，and the total incidence of adverse reactions was 8.0%.In the conventional dose group，one case was occurred with vertigo，one was digestive tract reaction，and one case with the increase of urea nitrogen.The total incidence of adverse reactions was 6.0%，which was not displayed difference after comparison （P>0.05）.Conclusion Atorvastatin can effectively improve cardiac function and blood lipid index after PCI in patients with CAD.The effect is better if used in a high dose of the drug with better safety，which is worthy of clinical promotion and application.

[Key words]Coronary heart disease；Interventional surgery；Atorvastatin；Dose；Cardiac function；Blood lipid

冠状动脉粥样硬化性心脏病（coronary atherosclerotic heart disease，CHD）简称为冠心病，是常见的心血管疾病，尤其多见于中老年患者。经皮冠状动脉介入手术是目前治疗此类疾病的一个重要方案，能够迅速、有效地改善冠状动脉狭窄或闭塞现象，改善血流供应，缓解症状[1-2]，但相关研究表明介入手术本身也会对血管造成一定程度的影响，尤其术后患者心功能和血脂水平存在异常改变[3-4]。大……