超短期他汀类药物治疗对非ST段抬高型急性冠脉综合征患者冠状动脉介入治疗术后再灌注及短期预后的影响  

Effects of Short-Term Statins Pre-treatment on Reperfusion and Short-Term Clinical Prognosis after Percutanous Coronary Intervention in Patients with Non ST-segment Elevation Acute Coronary Syndrome

作　　者：丁超[1] 李俊峡[1] 卫亚丽[1] 赵玉英[1] 张莉[1] 汝磊生[1] 李淑荣[1] 刘红娜[1] 

机构地区：[1]解放军白求恩国际和平医院心血管内科,河北省石家庄市050082

出　　处：《中国全科医学》2011年第1期49-51,共3页Chinese General Practice

摘　　要：目的探讨冠状动脉介入治疗(PCI)术前超短期应用他汀类药物对非ST段抬高型急性冠脉综合征(NSTE-ACS)患者心肌再灌注及短期预后的影响。方法将入院后72h内接受PCI的162例NSTE-ACS高危患者随机分为强化他汀治疗组和标准剂量他汀治疗组,于PCI术前服用辛伐他汀3d,观察PCI术前、术后即刻靶血管心肌梗死溶栓试验(TIMI)血流分级和心肌呈色分级(MBG)的差异,以及PCI术后24h肌酸激酶同工酶(CK-MB)的变化、PCI术后1个月心功能和主要心脏不良事件(MACE)的发生情况。结果两组间基础临床资料比较差异无统计学意义(P<0.05)。PCI术前强化组靶血管TIMI血流2～3级和MBG2～3级的比例显著高于标准组,差异有统计学意义(P<0.05)。PCI术后两组靶血管TIMI血流3级比例差异无统计学意义(P>0.05),强化组靶血管MBG2～3级的比例显著高于标准组,差异有统计学意义(P<0.05)。强化组CK-MB增高比例显著低于标准组,差异有统计学意义(P<0.05)。PCI术后1个月强化组左心射血分数(LVEF)为(0.58±0.09)%,明显好于标准组(0.53±0.08)%,差异有统计学意义(P<0.05)。强化组MACE发生率明显低于标准组,差异有统计学意义(P<0.05)。结论超短期大剂量服用他汀可明显改善NSTE-ACS高危患者PCI术后冠脉血流、心肌灌注和心功能,减少MACE的发生率。Objective To evaluate the effect of short - term pre - treatment with statins on the reperfusion and short - term clinical prognosis in patients with non ST - segment elevation acute coronary syndrome （ NSTE - ACS） who underwent successful primary percutanous coronary intervention （PCI） . Methods A total of 162 consecutive high - risk NSTE - ACS patients undergoing PCI within 72 hours were randomly divided into two groups： standard statin group received 20 mg simvastatin and intensive statin group received 80 mg simvastatin for 3 days before PCI. The difference of thrombolysis in myocardial infarction （TI- MI） and myocardial blush grade （MBG） of target arteries before and after PCI, serum level of CK - MB at 24h, left ventricular ejection fraction （LVEF） and the incidence of main adverse cardiac events （MACE） at 30 -day follow -up were examined in the 2 groups. Results The difference in basic clinical data between the two groups showed no statistical significance （ P 〈0. 05 ）. The percentage of TIMI grade 2 - 3 flow and MBG 2 - 3 perfusion were significantly higher in intensive statin group than those in standard statin group before PCI （ P 〈 0. 05 ）. The TIMI grade 3 flow in intensive statin group showed similar result to that in standard statin group after PCI （P 〉 0. 05 ）, but the percentage of MBG 2 - 3 perfusion in intensive statin group was significantly higher than that in standard statin group （P 〈 0. 05 ）. The incidence of increased CK - MB in intensive statin group was significandy lower than that in standard statin group （P 〈0.05）. One month after PCI the LVEF in intensive statin group [ （0. 58 ± 0. 09 ） % ] was higher than that in standard statin group [ （0. 53 ± 0. 08 ） % ] （ P 〈 0. 05 ）. The incidence of MACE （ P 〈 0. 05 ） in intensive statin group was also lower than that in standard statin group. Conclusion Pre - treatment with short - term statin of high - dose before PCI could improve the PCI postoperative coronary flo

关 键 词：他汀类药物 急性冠脉综合征 经皮冠脉介入治疗 无复流 

分 类 号：R541.7[医药卫生—心血管疾病] R542.2[医药卫生—内科学]