| Objective: coronary atherosclerotic heart disease is a kind of heartdisease because coronary atherosclerotic lead to coronary stenosis oremphraxis, or(and) because functionality changes of coronary, at last lead tomyocardial ischemia hypoxia or necrosis, which is called coronary heartdisease, also known ischemic heart disease. Acute coronary syndrome (ACS)including unstable angina, acute non-ST-segment elevation myocardialinfarction, acute ST-segment elevation myocardial infarction, is the mainreason for death and disability in patients with coronary heart disease.Compared with stable angina pectoris, a recurrence rate of significantincrease in adverse cardiovascular events in patients with acute coronanysyndrome, most occurred in the incidence of early.PCI (percutaneouscoronary interwention) is the cornerstone of treatment of patients with ACS,nearly20years of rapid development, but PCI increase the damage of thevascular wall, increasing the inflammatory response, the PCI perioperativemyocardial infarction incidence as high as30%to40%, perioperativemyocardial infarction is an important factor in prognostic. With the deepeningof understanding of the pleiotropic effects of statins, statin research hasgradually expanded to a perioperative application. In recent years, studieshave shown that application of statins three days or within24hours beforesurgery, to give a single high loading dose statin before PCI can reduceadverse cardiovascular events in patients with coronary heart disease PCIperioperative myocardial infarction and postoperative the risk of greatsignificance to the PCI expected results and improved patient outcomes. Thisstudy aimed to explore after PCI, atorvastatin stains calcium drug dosagesand blood cardiac enzymes, blood lipids, the correlation reveal the high-dose atorvastatin statins calcium after PCI in patients with myocardial protection.And thus improve the long-term prognosis and improve myocardial functionof patients after PCI to provide good treatment.Methods: Our hospital elective PCI patients with ACS99cases (male64cases,35females) were randomly divided into atorvastatin ting calciumconventional treatment group (50cases), atorvastatin ting calcium intensivetherapy group (49cases),the two groups were age, sex, risk factors (familyhistory of CAD, history of hypertension, diabetes and impaired glucosetolerance, smoking, body mass index, etc.) are comparable. The twogroups of patients after admission to other conventional treatment (aspirinenteric-coated tablets100mg/day,clopidogrel bisulfate75mg/day lowmolecular weight heparin5000U2/day subcutaneously). The conventionaltreatment group, preoperative and postoperative atorvastatin calcium standarddose (20mg/night oral) treatment, the intensive therapy group patientsbefore and after surgery using a large dose (60mg1/late oral) treatment.3days before surgery, after six hours, seven days after suegery were measured,CK-MB (creatine kinase MB), cTnI (troponin I), the TC (totalcholesterol), TG (triglycerides) and LDL (low density lipoprotein)levels.Results:1. Clinical characteristic differences in age, genderproportion of smokers, hypertensive, diabetic patients, the proportion ofgroup2patients before PCI, no significant (p>0.05). Differences in bloodlipids, liver function and other biochemical markers and other biochemicalcharacteristics was statistically significant (p>0.05). The blood ofmyocardial necrosis markers were no significant differences (p>0.05). Twosets of surgical success and no significant complications, coronaryangiography showed that the number of diseased vessels and the distributionof lesion was no significant difference (p>0.05).3hours after PCI, CKMBand cTnI levels of two groups of patients were elevated, the preoperativeand postoperative difference between the results of statistically significant.Between the two groups, the basis of the treatment group (20mg/night oral) postoperative CKMB and cTnI levels above the intensive therapy group of(60mg/night oral), the difference was statistically significant (p <0.05).7days after PCI, CKMB and cTnI levels of two groups of patients toreduce before surgery, no significant difference. Between the two groups,the basic treatment of postoperative CKMB and cTnI levels above theintensive therapy group, the difference was statistically significant (p <0.05).3.7days after PCI, two groups of blood lipids (CHOL, TG and LDL)compared with properative lower level, the difference was statisticallysignificant (p <0.05) between the two groups after7days, the basis of thetreatment of blood lipid (CHOL, TG and LDL) level is higher the intensivetherapy group, the difference was statistically significant (p <0.05).Conclusion: PCI can aggravate the damage of the vessel wall, increasethe infammatory response so that the blood of myocardial injury markersCKMB and cTnI levels before surgery as soon as possible to give atorvastatincalcium therapy to strengthen early patients can benefit, improve short-termprognosis. |
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