宋杰,雷媛,卢洪彪,龙艳丽,胡国智,李莎

• 1:武汉亚洲心脏病医院心外科
• 2:武汉大学中南医院消化内科

摘要(Abstract)：

目的探讨围手术期口服阿托伐他汀降脂药对冠状动脉旁路移植(coronary artery bypass grafting,CABG)术后患者心房颤动(atrial fibrillation,AF)的控制。方法298例行CABG术连续患者,根据围手术期是否予以阿托伐他汀药物分为他汀组及对照组各149例,分析比较两组术后心房颤动发生情况及超敏C反应蛋白(hs-CRP)、血脂水平变化。结果用统计学软件SPSS13.0处理,计数资料应用χ2检验或校正χ2,计量资料应用t检验,P值<0.05认为差异有统计学意义。结果他汀组和对照组在病史特点、手术操作及围手术期参数方面无统计学差异。术后房颤65例,总发生率21.8%,他汀组(14.8%)和对照组(28.9%)差异有显著统计学意义(χ2=8.677,P=0.003)。两组相比,他汀组症状性房颤发生率及房颤持续时间较对照组减少,差异有统计学意义(χ2=5.471,P=0.019;t=4.142,P=0.014)。Hs-CRP在两组中变化相似,术后3d水平最高,术后1周逐渐降低,术后3个月均能控制在正常低水平。对照组术后3d及1周较术前相比均有显著升高,差异具有统计学意义(t=1.746和2.818,P<0.05)。同期比较,他汀组术后3d及1周hs-CRP显著低于对照组(t=16.344和6.029,P<0.05)。他汀组和对照组血总胆固醇浓度在术后1周及3个月较术前比较均有显著降低(t=1.675和1.376,P<0.05;t=1.413和1.472,P<0.05)。结论围手术期口服阿托伐他汀除对CABG术后患者的血脂有效调节外,对全身炎症反应有明显减轻,并可降低术后房颤的发生率并缩短持续时间,且无肝肾功能损伤等并发症。

关键词(KeyWords)： 阿托伐他汀;冠状动脉旁路移植术,非体外循环;心房颤动;C反应蛋白

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 宋杰,雷媛,卢洪彪,龙艳丽,胡国智,李莎

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