PCI围术期单次高负荷量阿托伐他汀对抗血小板药物影响.docVIP

PCI围术期单次高负荷量阿托伐他汀对抗血小板药物影响 　　摘要:目的 观察经皮冠状动脉介入（PCI）治疗前服用80 mg阿托伐他汀对围术期抗血小板药物疗效有无影响。方法 入选行择期PCI的87例冠心病患者。随机分为两组,高剂量组予冠心病基础药物治疗，并在PCI前8 h内给予单次高负荷剂量（80 mg）阿托伐他汀；对照组仅予基础药物治疗。PCI术前24 h内均给予负荷剂量的阿司匹林（300 mg）及氯吡格雷（300 mg）。PCI后24 h测血栓弹力图，3 d后复查血栓弹力图。结果 术后24 h、3 d时两组抗血小板药物对血小板抑制率比较无统计学意义（P0.05）。结论 对于稳定型心绞痛及心肌标志物水平正常的不稳定型心绞痛患者，介入术前给予单次80 mg阿托伐他汀不影响抗血小板药物的疗效。 　　关键词：冠心病；经皮冠状动脉成形术；羟甲基戊二酰辅酶A还原酶抑制剂；氯吡格雷 　　中图分类号：R815 文献标识码：B 文章编号：1672-1349（2011）08-0923-02 　　 　　Influence of Single High Loading Dose of Atorvastatin on Antiplatelet Drugs during Perioperative Period of PCI 　　Li Xin，Liu Yunbao，Huang Chaolian，et al 　　Heart Center，First Hospital of Tsinghua University （Beijing 100016） 　　Abstract:Objective To investigate the influence of single high loading dose of atorvastatin（80 mg） on antiplatelet drugs during perioperative period of percutaneous coronary intervention （PCI）.Methods A total of 87 patients （pts） with coronary artery disease who underwent selective PCI was enrolled in this study and randomized into two groups：Control group treated with routine medication，and the atorvastatin group treated with single loading of 80 mg atorvastatin within 8 hours before PCI.All pts in two groups were given a single loading of 300 mg aspirin and 300 mg clopidogrel within 24 hours before PCI.Thromboelastograms（TEG） was checkedwithin 24 hours after PCI and three days later.Results The platelet inhibition ratios of antiplatelet drugs in the two groups were no significant statistical differences（P0.05）.Conclusion The effectiveness of antiplatelet was not affected by a single high loading dose of 80 mg atorvastatin given prior to PCI in pts with stable angina and unstable angina patients with normal cardiac markers. 　　Key words: coronary artery disease；percutaneous coronary angioplasty；3-hydroxy-3-methylglutaryl coenzyme A；clopidogrel 　　 　　他汀类药物因具有降低低密度脂蛋白、抑制炎症、稳定斑块等多种有益作用而广泛应用于冠心病患者。2009年NAPLESⅡ研究证实单次、大剂量（80 mg）、短时间内（24 h内）给予阿托伐他汀具有心脏保护的作用，并降低围术期心肌梗死的发生率［1］。氯吡格雷目前已广泛应用于冠状动脉介入（PCI）术后预防血栓