| Objective In the recent twenty years, the percutaneous coronary intervention (PCI) has made great progress, and become an important method of the treatment for the coronary heat desease (CHD), restenosist in-coronary-stent and the increased incidence of cardiology are still problems for its clinical application. The studies revealed that perioperative myocardial infarction is related to the increasing rate of death after the operation. The recent reports showed that if the patients taken statins for over 3 days or took overdose statins befor operation, it will decrease the myocardial infarction and cardiology resulting from the PCI treatment and has great effect on the result of PCI treatment. In this paper, we studied the protective effect of atorvastatin on the acute coronary syndrome patients (ACS) who taken regular dose for over 3 days and increase the different doses befor the PCI operation. At the same time, we also studied the effect of the intensive atorvastatins treatment on the inflammatory cytokines such as high-sensitivity C-reactive protein (hs-CRP), nterleukins (IL)-6.Methods In this study, Ninty ACS patients in our hospital was randomly divided into three groups which did not take atorvastatins at 12 hours befor PCI operation, took higher doses (40mg) and highest doses (80mg) respectively. the patients of the divided three groups have good comparability in terms of the clinical characteristica such as age, sex, risk factor (smoking, history of diabetes, cholesterol, hypertension and family history of CHD et al.). Then, we determined the creatine kinase MB (CK-MB), troponin I(cTnâ… ) of patients before operation,6 and 12 hours after operation; determined hs-CRP and IL-6 content befor operation and 12 hours after operation; detected the total cholesterol (TC), triglyceride (TG), low-density lipoprorein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), liver and kidney functions befor operation and 3 days after treatment. Finally all data are analyzed by the SPSS statistical software.Results The results showed that the content of cTnâ… and CK-MB in groupl and group2 are higher than that of before operation after the PCI, and the content of cTnâ… and CK-MB in Group 3 don,t increase among preoperative,6 hours of postoperative, and 12 hours of postoperative. Compared with groupl and group2, the levels of cTnâ… and CK-MB in the group3 have significantly decreased at 6 hours and 12 hours postoperative, and compared with group 2 there has been a marked declination at 12 hours postoperative while the levels of cTnâ… and CK-MB in the group2 has no statistically significant difference at 6 hours and 12 hours postoperative between groupl and group3 (P>0.05). The incidence of the elevated cTnâ… content is respectively 36.6%,23.3% and 16.7% among three groups, The incidence of CK-MB elevated is respectively 33.3%,16.7% and 10.0%, however the incidence is no statistically significant difference (P>0.05); secondly, the increase of the cTnâ… content is related to the time, frequency and pressure of ballon pre-expansion and inserted stent number, however, is independent of age, sex, history of diabetes, hypertension and family history of CHD; After the operation the hs-CRP and IL-6 content of all patients increased, however, the hs-CRP and IL-6 content of the group3 is inferior to that of the group1 and the group 2, moreover it is inferior to that of the group2 at 12 hours after the operation; the blood lipid, liver and kidney functions for all patients taken on a slight change after they taken the statins.Conclusions (1) PCI treatment will result in myocardial damage, and the reducing of the time, frequency and pressure of ballon pre-expansion is expected to decrease the perioperative myocardial damage; (2) For the ACS patients who has taken the regular doses of atorvastatins, giving the enhanced atorvastatins(80mg) 12 hours befor the PCI operation will further reduce the myocardial damage. (3) PCI treatment will induce the reaction of acute lendothelial inflammation, however, intensive atorvastatins(80mg) treatment can restrain the inflammtion reaction of ACS patients after the PCI. (4) On the base of nomal dose, the intensive treatment of a single injection has a slight effect on blood lipid in the short term, and also good safety. |
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