阿伐他汀对心脏病人非心脏手术围手术期心血管事件发生率的影响

发布时间：2018-05-18 21:17

本文选题：阿托伐他汀 + 心脏病　；参考：《河北医科大学》2015年硕士论文

【摘要】：目的:本研究通过观察术前应用阿托伐他汀对冠心病患者非心脏手术围手术期心血管死亡率的影响,旨在指导心脏病患者非心脏手术围手术期用药。方法:选择2013-12~2014-12在河北省四院的非心脏手术的心脏病患者,入选200例。其中试验组96例,对照组104例。采用随机数字表随机分为两个组,试验组与对照组。排除标准:口服药物困难患者;活动性肝病或原因不明的转氨酶持续升高患者;近期新发生脑出血患者;高危手术患者;对阿托伐他汀过敏者;术中出现其他由于手术本身意外导致心脏并发症。在常规治疗基础上,术前7天开始给予口服阿托伐他汀(辉瑞制药有限公司,商品名:立普妥,国药准字H20051407)20mg/次,每日1次。对照组不给药。为了使患者依从性更好,入选患者出院后进行电话随访。由专人负责,对心脏病人非心脏手术围手术期血压、脉搏、心电监护、中心静脉压监测,观察心电图ST-T变化,随访术后心血管事件发生率(监测血压、心电图、心脏彩超变化)以及围术期心梗、心绞痛、房颤、室早、肾衰竭、血脂、心性死亡率,由专人记录。所有患者资料均用光盘保存,用于前后对比。结果:试验组房颤、室早发生率低于对照组,差异有统计学意义(P0.05)。观察组治疗后甘油三脂(TG)、总胆固醇(TC)低于对照组,但P0.05,无统计学差异。结论:口服阿托伐他汀,20mg/次,每日1次,能有效稳定冠心病患者非心脏手术治疗过程中心律失常等不良心脏事件。其作用机制可能与阿托伐他汀能有效降低血脂水平,抑制炎症反应,减轻炎症反应对心肌细胞损伤有关。
[Abstract]:Objective: to investigate the effect of preoperative Atto vastatin on perioperative cardiovascular mortality in patients with coronary heart disease (CHD). Methods: 200 patients with non-cardiac heart disease were selected from the fourth Hospital of Hebei Province in 2013-12 and 2014-12. There were 96 cases in the test group and 104 cases in the control group. Two groups were randomly divided into two groups: the experimental group and the control group. Exclusion criteria: patients with oral difficulty with drugs; patients with active liver disease or elevated transaminase with unknown cause; patients with recent new cerebral hemorrhage; patients with high-risk surgery; patients allergic to Atto; There were other cardiac complications due to the operation itself. On the basis of routine therapy, oral Atto vastatin was given 7 days before operation (Pfizer Pharmaceutical Co., Ltd., trade name: Lipitor, H20051407)20mg/ times of Chinese medicine, once a day. The control group was not administered. In order to improve compliance, the selected patients were followed up by telephone after discharge. The blood pressure, pulse, ECG monitoring, central venous pressure monitoring, ST-T changes, cardiovascular events (monitoring blood pressure, electrocardiogram) in patients with non-cardiac surgery were observed. Myocardial infarction, angina pectoris, atrial fibrillation, ventricular premature, renal failure, blood lipid, cardiac death rate, recorded by special person. All patient data were saved on CD for comparison before and after. Results: the incidence of atrial fibrillation and ventricular premature in the trial group was lower than that in the control group (P 0.05). The levels of TGG and TC in the observation group were lower than those in the control group, but there was no significant difference between the two groups (P 0.05). Conclusion: oral administration of Atto vastatin 20 mg / time once a day can effectively stabilize arrhythmia and other adverse cardiac events in patients with coronary heart disease during non-cardiac surgery. The mechanism may be related to the effect of Atto vastatin on reducing blood lipid level, inhibiting inflammatory response and alleviating the injury of myocardial cells.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R541;R619

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