RESUMO
Objective To investigate the effect of atorvastatin on the expressions of solubility P-selectin(sP-selectin) and high sensitive C reactive protein(hs-CRP) in patients with percutaneous coronary intervention (PCI),and to explore the protective effect of atorvastatin on myocardium.Methods A total of 100 acute coronary syndrome patients having underwent successful PCI were enrolled in this study.All patients were divided into 3 groups by random digits table method:standard treatment group (group A,30 patients,atorvastatin 20 mg),low-dose atorvastatin pretreatment group (group B,35 patients,preoperative 12 h and 2 h atorvastatin 40 mg and 20 mg,respectively) and high-dose atorvastatin pretreatment group (group C,35 patients,preoperative 12 h and 2 h atorvastatin 80 mg and 40 mg,respectively).The level of sP-selectin was measured with ELISA.The level of hs-CRP was measured with latex enhanced immunoturbidimetry.Results Before operation,the levels of sP-selectin in group A,B,C were (2.32 ±0.40),(2.51 ± 0.33),(2.47 ± 0.28) μ g/L.After 6 and 12 h of operation,the levels of sP-selectin in group A,B,C were (4.12 ± 0.75),(3.34 ± 0.42),(3.31 ± 0.46) μ g/L and (5.64 ± 1.07),(4.08 ± 0.74),(3.84 ±0.48) μg/L.The levels of sP-selectin in group A,B,C after operation were significantly higher than that before operation (P ＜ 0.05).At the same time point,the levels of sP-selectin in group B,C after operation were significantly lower than that in group A (P＜ 0.05).Before operation,the levels of hs-CRP in group A,B,C were (4.32 ±0.51),(4.46 ±0.57),(4.29 ±0.43) mg/L,after 6 and 12 h of operation,the levels of hs-CRP in group A,B,C were (8.91 ± 1.34),(7.44 ± 1.06),(7.28 ±0.95) mg/L and (13.66 ± 1.49),(8.08 ± 1.14),(7.92 ± 1.04) mg/L.The levels of hs-CRP in group A,B,C after operation were significantly higher than that before operation (P＜ 0.05).At the same time point,the levels of hs-CRP in group B,C after operation were significantly lower than that in group A (P ＜ 0.05).The analysis of Pearson correlation showed,the level of sP-selectin was positively related with hs-CRP (r =0.753,P ＜0.01).The incidence of perioperative myocardial infarction was 23.3％ (7/30),5.7％ (2/35) and 2.9％ (1/35) in group A,B and C,respectively.The incidence in group A was significantly higher than that in group B and C (P ＜ 0.05).But there was no significant difference between group B and group C (P＞ 0.05).Conclusion The atorvastatin pretreatment can decrease the levels of sP-selectin and hs-CRP in patients after PCI,which play an important role in myocardium protection.