Impacts of preoperative load statins on postoperative blood high sensitive C-reactive protein,tumor necrosis factor-α,P-selectin levels in patients with acute coronary syndrome / 中国医师进修杂志

ABSTRACT

Objective To observe the changes of postoperative blood high sensitive C-reactive protein (hs-CRP), tumor necrosis factor(TNF)-o, P-selectin levels in patients with acute coronary syndrome (ACS) who had an atorvastatin intensive treatment before operation, and investigate its clinical significance.Methods Seventy-eight cases of ACS patients who intended to undergo percutaneous coronary intervention were divided into two groups by random digits table39 patients comprising the standard treatment group (given atorvaatatin 20 mg/d, conventional treatment), 39 patients comprising the enhanced group (given atorvastatin 40 mg, 20 mg separately at preoperative 12 h, 2 h on the basis of conventional treatment).Among them, 28 cases of the standard treatment group and 29 cases of the enhanced group finally underwent the test. The hs-CRP,TNF-α ,P-selectin levels at preoperative 1 day,postoperative 6 h,postoperative 12 h were detected and then the changes of three factors were analyzed. Results There was no significant difference in hs-CRP,TNF- α, P-selectin between the two groups at preoperative 1 day. The values of the two groups markedly increased at postoperative 6 h, 12 h and the difference was statistically significant (P ＜0.05). The values of the standard treatment group were markedly higher at postoperative 12 h than those at postoperative 6 h,and the difference was statistically significant [hs-CRP (10.29 ± 0.77) mg/L vs. (6.34 ±1.23) mg/L;TNF-α (58.15±5.19) ng/L vs. (36.12 ± 3.89) ng/L;P-selectin (49.58 ±4.92) μg/L vs.(31.47 ± 3.71) μ g/L] (P ＜ 0.05). However, the values of the enhanced group were higher at postoperative 12 h than those at postoperative 6 h but the difference was no statistically significant [hs-CRP (6.83 ± 1.46)mg/L vs. (5.95 ± 1.17) mg/L; TNF- o (42.18 ± 7.79) ng/L vs. (34.07 ± 8.79) ng/L; P-selectin (33.57 ±4.63) μ g/L vs. (29.78 ± 5.61) μ g/L] (P ＞ 0.05). Three factors in standard treatment group were elevating significantly at postoperative 6 h, 12 h compared with those in the enhanced group, but the difference was no statistically significant (P ＞ 0.05). Conclusion Short-term intensive therapy of atorvastatin in ACS patients who intend to do PCI, can reduce the hs-CRP, TNF-α, P-selectin levels effectively.