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目的观察负荷量阿托伐他汀对急性冠脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术后的影响及血浆CC趋化因子受体1(CCR1)在其中的作用。方法 120例ACS患者随机均分为试验组和对照组,试验组入院后30min内给予阿托伐他汀80mg,PCI术当日起40mg/d,30d后改为20mg/d;对照组入院后起即给予阿托伐他汀20mg/d。观察两组围术期心肌梗死及30d主要不良心血管事件(MACE)的发生率;ELISA法检测术前、术后24h、1、2、4周血浆CCR1水平。结果试验组围手术期心肌梗死发生率明显低于对照组(5.00%vs.23.33%)(P<0.01);30dMACE发生率低(3.33%vs.15.00%)(P<0.05)。与PCI术前比较,对照组术后24h血浆CCR1明显升高(P<0.01);两组术后1、2、4周两组CCR1的水平均明显下降(P<0.01),试验组低于对照组(P<0.01)。结论术前强化阿托伐他汀治疗显著降低ACS患者PCI术后CCR1水平,从而减少围手术期心肌梗死和30dMACE发生率。
Objective To investigate the effects of atorvastatin on patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) and the role of plasma CC chemokine receptor 1 (CCR1). Methods A total of 120 patients with ACS were randomly divided into experimental group and control group. Atorvastatin 80 mg was given within 30 minutes after admission in the experimental group, 40 mg / d on the day of PCI and 20 mg / d 30 days later. In the control group, Atorvastatin 20 mg / day was given. The incidence of perioperative myocardial infarction and major adverse cardiovascular events (MACE) at 30 days were observed. The levels of plasma CCR1 in preoperative and postoperative 24h, 1, 2 and 4 weeks were detected by ELISA. Results The incidence of perioperative myocardial infarction in the experimental group was significantly lower than that in the control group (5.00% vs.23.33%, P <0.01). The incidence of 30-day MACE was lower (3.33% vs.15.00%, P <0.05). The CCR1 level in control group was significantly higher than that in PCI group at 24 hours after operation (P <0.01). The levels of CCR1 in both groups were significantly decreased at 1, 2 and 4 weeks after operation (P <0.01) Control group (P <0.01). Conclusions Pretreatment with atorvastatin can significantly reduce the level of CCR1 after PCI in ACS patients, and reduce the incidence of perioperative myocardial infarction and 30dMACE.