首页|阿托伐他汀联合秋水仙碱对经皮冠脉介入术后支架内再狭窄的临床研究

阿托伐他汀联合秋水仙碱对经皮冠脉介入术后支架内再狭窄的临床研究

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目的 探讨阿托伐他汀钙片(ACT)联合秋水仙碱(COL)对经皮冠状动脉介入(PCI)术后支架内再狭窄(ISR)的预防作用。方法 回顾性分析2020年1月至2023年6月简阳市人民医院PCI术后急性冠脉综合征(ACS)患者的临床资料。根据PCI术后治疗方案分为ACT组(阿司匹林肠溶片+硫酸氢氯吡格雷片+ACT)和联合组(阿司匹林肠溶片+硫酸氢氯吡格雷片+ACT+COL)。观察指标包括支架内最小管腔内径(MLD)、ISR率、血脂参数[高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、总胆固醇(TC)和甘油三酯(TG)]和炎症指标[超敏C反应蛋白(hs-CRP)和白细胞介素-35(IL-35)]。观察并记录主要不良心血管事件(MACEs)发生率和药物相关不良反应发生率。结果 研究共纳入患者479例,ACT组249例,联合组230例。两组术后即刻MLD差异无统计学意义(P>0。05),术后12个月后,两组患者MLD均显著下降(P<0。05),且联合组低于ACT组(P<0。05)。联合组ISR率显著低于ACT组(P<0。05)。两组术前血脂参数、炎症指标差异均无统计学意义(P>0。05)。术后12个月LDL、TG、TC、hs-CRP较术前均显著下降,而HDL和IL-35较术前均显著上升(P<0。05)。术后12月,两组HDL、LDL、TC和TG差异无统计学意义(P>0。05);与ACT组比较,联合组hs-CRP水平显著降低,而IL-35水平升高(P<0。05)。MACEs方面,联合组心肌再梗死率和任何MACEs事件发生率均低于ACT组(P<0。05),而紧急冠状动脉血管重建术率、脑卒中率和心源性死亡率差异无统计学意义(P>0。05)。药物相关不良反应方面,两组胃肠道反应发生率、出血发生率、血细胞减少发生率、转氨酶升高发生率、肌肉酸痛发生率、感染发生率和任何相关不良事件发生率差异无统计学意义(P>0。05)。结论 ACT联合COL可改善PCI术后ACS患者炎症水平,降低ISR发生率和MACEs发生率但对血脂参数影响较小,且不增加药物相关不良反应。
Clinical study of atorvastatin combined with colchicine for in-stent restenosis after percutaneous coronary intervention
Objective To investigate the preventive effect of atorvastatin calcium tablets(ACT)combined with colchicine(COL)on in-stent restenosis(ISR)after percutaneous coronary intervention(PCI).Methods Clinical data of patients with acute coronary syndrome(ACS)after PCI at Jianyang People's Hospital from January 2020 to June 2023 were retrospectively analyzed.According to the postoperative treatment plans after PCI,they were divided into the ACT group(Aspirin enteric-coated tablets+Clopidogrel bisulfate tablets+ACT)and the combined group(Aspirin enteric-coated tablets+Clopidogrel bisulfate tablets+ACT+COL).The observation indicators include minimum lumen diameter(MLD)within the stent,ISR rate,blood lipid parameters(HDL,LDL,TG,and TC),and inflammatory markers(hs-CRP and IL-35).In addition,the incidence of major adverse cardiovascular events(MACEs)and drug-related adverse reactions were observed and recorded.Results A total of 479 patients were included in the study,with 249 cases in the ACT group and 230 cases in the combined group.The difference in MLD between the two groups in the immediate postoperative period was not statistically significant(P>0.05),and at 12 months postoperatively,the MLD of patients in both groups decreased significantly(P<0.05),and the MLD of the combined group was lower than that of the ACT group(P<0.05).The ISR rate was significantly lower in the combined group than in the ACT group(P<0.05).The differences in preoperative lipid parameters and inflammation indicators between the two groups were not statistically significant(P>0.05).LDL,TG,TC,and hs-CRP decreased significantly at 12 months postoperatively compared with preoperative period,while HDL and IL-35 increased significantly compared with preoperative period(P<0.05).At 12 months postoperatively,the differences in HDL,LDL,TC,and TG between the two groups were not statistically significant(P>0.05);compared with the ACT group,the hs-CRP levels in the combined group decreased significantly,whereas the IL-35 levels were elevated(P<0.05).With regard to MACEs,the rate of myocardial re-infarction and the incidence of any MACEs events in the combined group were lower than those in the ACT group(P<0.05),and the rate of emergency coronary revascularization,stroke and cardiac mortality were not statistically different(P>0.05).Regarding drug-related adverse reactions,the differences between the two groups in the incidence of gastrointestinal reactions,the incidence of bleeding,the incidence of hematopenia,transaminase elevation,muscle soreness,infection,and any related adverse events were not statistically significant(P>0.05).Conclusion ACT combined with COL improve inflammation levels and reduce the incidence of ISR and MACEs,in ACS patients after PCI,but has a smaller impact on blood lipid parameters.and without adding additional drug-related adverse reactions.

Atorvastatin calcium tabletsColchicineIn stent restenosisPercutaneous coronary interventionAcute coronary syndromeMajor adverse cardiovascular events

王君、杨晓瑜、黄祖荣、魏坤、张跃龙、王英

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简阳市人民医院心血管内科(四川简阳 641400)

四川护理职业学院附属医院/四川省第三人民医院心血管内科(成都 610000)

阿托伐他汀钙片 秋水仙碱 支架内再狭窄 经皮冠状动脉介入术 急性冠脉综合征 主要不良心血管事件

2024

中国药师
国家药品监督管理局高级研修学院,武汉医药(集团)股份有限公司

中国药师

CSTPCD
影响因子:0.944
ISSN:1008-049X
年,卷(期):2024.28(9)