急诊经皮冠状动脉介入治疗前强化阿托伐他汀对急性心肌梗死患者的中期疗效观察  

Intermediate clinical outcome in acute myocardial infarction patients after intensive atorvastatin treatment before emergency PCI

作　　者：苑雯雯[1] 杨勇[2] 赵旭燕[2] 毛积分[2] 刘惠亮[2] 

机构地区：[1]辽宁医学院研究生学院,锦州121001 [2]武警总医院心内科

出　　处：《中华老年心脑血管病杂志》2012年第9期903-906,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨急性ST段抬高心肌梗死(STEMI)患者术前强化阿托伐他汀治疗的中期临床疗效。方法对拟行急诊PCI治疗的102例STEMI患者随机分为A组32例,B组32例,C组38例。观察术后90 min内ST段回落、术后24、72 h高敏C反应蛋白(hs-CRP)、术后肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)峰值及术后6个月主要不良心血管事件。结果 3组患者入院和术后24 h hs-CRP比较,差异无统计学意义(P>0.05)。与A组比较,B组、C组术后72 h hs CRP明显升高(P<0.05)。术前3组CK与CK-MB比较,差异无统计学意义(P>0.05)。与A纽比较,B组、C组术后CK、CK-MB明显升高,ST段回落均值及发生率明显降低(P<0.05)。A组、B组、C组术后6个月主要心血管不良事件发生率分别为9.4%、9.4%和10.5%,差异无统计学意义(P>0.05)。结论急诊PCI术前强化阿托伐他汀治疗可抑制STEMI患者炎性反应,减轻心肌梗死范围。Objective To observe the intermediate clinical outcome in patients with STEMI who re- ceived intensive atorvastatin treatment before emergency PCI. Methods STEMI patients under- going emergency PCI were randomly divided into group A（n=32）, group B（n= 32）and group C （n：38）. Patients in group A received 80 mg atorvastatin daily before PCI followed by 40 mg ator- vastatin daily for 1 month and a maintenance dose of 20 mg atorvastati daily thereafter. Patients in group 13 were given 40 mg atorvastatin daily for 1 month after PCI and a maintenance dose of 20 mg atorvastatin daily thereafter. Patients in group C administered 20 mg atorvastatin daily after PCI. STR were evaluated at 90 min after PCI,hs-CRP were assayed 24 h and 72 h after PCI. Peak CK and CK-MB levels were measured and MACE were recorded 6 months after PCI. Results No significant difference was found in hs-CRP level among the 3 groups at admission and 24 h after PCI（P〉0.05）. The hs-CRP level was significantly higher in groups B and C than in group A at 72 h after PCI（P〈0.05）while no significant difference was observed in hs-CRP level between groups B and C. No significant difference was found in CK and CK-MB level among the 3 groups before PCI. The peak CK and CK-MB levels were significantly higher while the average value and incidence of STR were significantly lower in groups B and C than in group A（P〈0.05）. The inci- dence of MACE was 9.4% ,9.40/60 and 10.5% respectively in 3 groups（P〉0.05）. Conclusion In- tensive atorvastatin treatment of STEMI patients before emergency PCI can inhibit inflammatory reactions and alleviate myocardial infarction.

关 键 词：心肌梗死 C反应蛋白质 肌酸激酶 羟甲基戊二酰基COA还原酶抑制剂 微循环 

分 类 号：R542.22[医药卫生—心血管疾病]