高剂量瑞舒伐他汀对PCI术后患者血小板功能影响.docVIP

高剂量瑞舒伐他汀对PCI术后患者血小板功能影响 　　【摘要】 目的：研究高?┝咳鹗娣ニ?汀对PCI术后患者血小板功能影响，进一步探讨他汀类药物与血小板功能的关系。方法：92例择期行PCI术的冠心病患者分为瑞舒伐他汀5 mg组（R5组，n=30）、瑞舒伐他汀20 mg组（R20组，n=31）、阿托伐他汀20 mg组（A20组，n=31），同期行冠脉造影的非冠心病患者30例作为单纯冠状动脉造影组（单纯CAG组）。通过流式细胞检测术，比较术前及术后24 h四组血小板活化标志物CD62P、CD63变化。结果：R5、R20和A20组CD62P百分率术后较术前均有不同程度的升高（P0.05）。与R20组相比，R5、A20组术后CD62P百分率显著升高，差异均有统计学意义（P0.05）。术后，R5、A20组CD63百分率明显高于R20组，差异均有统计学意义（P0.05）；R20组CD63百分率与单纯CAG组比较，差异无统计学意义（P0.05）。结论：血小板活化标志物检测表明经皮冠脉介入术术后循环外周血小板活性增高，对评估术后患者血小板功能状态具有积极意义；瑞舒伐他汀具有抑制血小板作用，并随剂量升高而加强，并且安全有效，PCI术前负荷剂量服用可使患者获益更多。 　　【关键词】 瑞舒伐他汀； 经皮冠状动脉介入治疗； CD62P 　　【Abstract】 Objective：To assess the influence of high dose Rosuvastatin on platelet function in patients after PCI.Method：A total of 92 coronary heart disease（CHD） patients underwent PCI were divided into Rosuvastatin 5 mg group（R5 group，n=30），Rosuvastatin 20 mg group（R20 group，n=31） and Atorvastatin 20 mg（A20 group，n=31），30 non-CHD patients were recruited as the coronary arteriongraphy group（CAG group）.Platelet activation markers CD62P and CD63 of four groups were examined by flow cytometry before operation and 24 hours after operation.Result：The percentage of CD62P in R5 group，R20 group and A20 group were significantly increased after operation（P0.05）.Compared with the R20 group，the percentage of CD62P in R5 group and A20 group were significantly higher，the differences had statistical significance（P0.05）.After operation，the percentage of CD63 in R5 group and A20 group were significantly higher than R20 group，the differences had statistical significance（P0.05）；and there was no difference in the percentage of CD63 in R20 group and CAG group（P0.05）.Conclusion：The results of platelet activation markers indicate that peripheral platelet is remarkable activated after PCI，which may be a effective method to evaluate platelet function after PCI；Rosuvastatin has an effect to inhibit platelet function，and it’s dose related，which indicated patients can be benefited from loading doses of Rosuvastatin before PCI. 　　【Ke