王泽丰

摘 要 目的：探讨阿托伐他汀应用剂量对冠心病合并睡眠呼吸暂停综合征（SAS）患者经皮冠状动脉介入治疗（PCI）术后的影响。方法：选取72例冠心病合并SAS患者为研究对象，按照随机数表法分3组，每组24例，分别于术后给予阿托伐他汀80 mg/d（Ⅰ组）、40 mg/d（Ⅱ组）和20 mg/d（Ⅲ组）。比较治疗后患者炎症因子水平及左心室功能变化。结果：PCI手术6个月后，Ⅰ组和Ⅱ组的BNP和MMP-9水平相比Ⅲ组明显降低，而Ⅰ组的hs-CRP明显低于Ⅱ组和Ⅲ组；Ⅰ组和Ⅱ组的LVEF水平高于Ⅲ组（P<0.05）。结论：加载负荷剂量阿托伐他汀治疗可减少PCI术后早期的炎症反应，并有利于增进术后远期左心室的重塑功能，对持续改善患者的心脏功能有显著的效果。

关键词 他汀类药物 应用剂量 冠心病并发睡眠呼吸暂停综合征 经皮冠状动脉介入治疗

中图分类号：R972.6； R541.4 文献标志码：B 文章编号：1006-1533（2021）03-0015-03

Effects of different dosages of atorvastatin on the PCI in patients with coronary heart disease complicated with sleep apnea syndrome

WANG Zefeng（the Second Department of Internal Medicine， the Third Peoples Hospital of Jieyang City， Guangdong Jieyang 522000， China）

ABSTRACT Objective： To investigate the effect of atorvastatin dosages on percutaneous coronary intervention （PCI） in patients with coronary heart disease （CHD） complicated with sleep apnea syndrome （SAS）. Methods： Seventy-two patients with CHD complicated with SAS were selected and divided into group Ⅰ， Ⅱ and Ⅲ with 24 cases each based on a random number table method. They were treated with 80， 40 and 20 mg/d of atorvastatin after operation， respectively and the changes of inflammatory factors and left ventricular function were compared among the three groups. Results： After PCI surgery for six months， the levels of BNP and MMP-9 were significantly decreased and the LVEF levels were significantly higher in group Ⅰ and Ⅱ compared with group Ⅲ， and the hs-CRP levels were obviously lower in group Ⅰ than group Ⅱ and Ⅲ （P<0.05）. Conclusion： The therapy of the loading dose of atorvastatin can reduce the early postoperative inflammatory response in the patients， and is beneficial to improve the long-term postoperative remodeling function of the left ventricle and has a significant effect on the continuous improvement of cardiac function.

KEY WORDS statins； application dose； coronary heart disease complicated with sleep apnea syndrome； percutaneous coronary intervention

冠心病（coronary heart disease，CHD）是以冠狀动脉血管粥样硬化所致血管腔狭窄或阻塞为主要病变基础的常见心脏疾病，临床表现为心肌缺血、缺氧症状[1]。睡眠呼吸暂停综合征（sleep apnea syndrome，SAS）是一种病因不明的睡眠呼吸疾病，由于呼吸暂停所导致的夜间低氧和高碳酸血症反复发作，可加重高血压，冠心病，糖尿病和脑血管等疾病的严重程度，甚者可导致患者死亡，因此是心血管事件的独立危险因素之一[2]。目前，临床研究已证实，炎症因子水平的变化与CHD严重程度密切相关，因此，通过观察经皮冠状动脉介入治疗（percutaneous coronary intervention，PCI）后CHD患者炎性因子水平的变化特点有助于评估治疗效果和疾病转归[3]。他汀类药物是治疗PCI术后CHD的重要药物，但剂量应用一直是临床关注的焦点，并少有研究对CHD并发SAS患者进行针对性研究。鉴于此，本研究以CHD合并SAS患者为研究对象，对不同剂量下患者炎症因子水平以及心功能的变化特点进行分析，旨在为优化临床治疗方案提供依据。……