急性心肌梗死急诊介入治疗后辛伐他汀对早期左心室重构的影响  

Effect of simvastatin on early left ventricular remodeling in acute myocardial infarction patients after emergency PCI

作　　者：谢晓春[1] 邹建宏[1] 张丽娟[1] 

机构地区：[1]第二炮兵总医院心内科,北京100088

出　　处：《中华老年心脑血管病杂志》2013年第4期349-352,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨急性心肌梗死(acute myocardial infarction,AMI)急诊直接PCI术后使用辛伐他汀对早期左心室重构的影响。方法选择AMI接受急诊直接PCI患者245例,随机分为辛伐他汀治疗组(治疗组)123例和对照组122例。比较2组术后即刻TIMI分级、计算校正TIMI计帧数(cTFC)和心肌Blush分级。采用彩色多普勒超声心动仪分别于发病早期(<24h)、1、2、3周末连续测量、计算左心室形态、构型等指标并进行分析。结果与基线比较,对照组1周末左心室收缩末内径(LVESD)、左心室短轴前半径(Ra)/内径(D)明显升高,2周末左心室舒张末内径(LVEDD)、LVESD、Ra/D、左心室前部心内膜弧长(ASL)、后部心内膜弧长(PSL)明显升高,3周末LVEDD、LVESD、Ra/D、ASL、PSL、LVEF明显升高,差异有统计学意义(P<0.05,P<0.01);治疗组2周末LVEDD、LVESD、PSL、LVEF明显升高,3周末LVEDD、LVESD、ASL、PSL、LVEF明显升高(P<0.05,P<0.01)。与对照组比较,治疗组2周末、3周末LVEDD、LVESD、Ra/D、ASL、PSL明显降低,LVEF明显升高,差异有统计学意义(P<0.05)。结论 AMI患者急诊直接PCI术后,使用辛伐他汀对早期左心室重构有抑制作用。Objective To study the effect of simvastatin on early left ventricular remodeling in acute myocardial infarction（AMI） patients after emergency percutaneous coronary intervention （PCI）. Methods Two hundred and forty-five AMI patients undergoing emergency PCI were ran- domly divided into simvastatin treatment group（n= 123） and control group（n= 122）. Their TIMI grade,corrected TIMI frame count（cTFC） and myocardial blush grade were compared immediate- ly after PCI. Indexes of left ventricular shape and geometry were measured by color Doppler echo- cardiography at 〈24 h and weekends 1,2 and 3,respectively. Results The LVESD and left ven- tricnlar Ra/D at weekend 1,the LVEDD,LVESD,left ventricular Ra/D,left ventricular ASL and PSL at weekends 2 and 3 were significantly higher than their baseline parameters in control group （P〈0.05 ,P〈0.01）. The LVEDD,LVESD,left ventricular ASL and PSL at weekend 2 were sig- nificantly lower while the LVEDD,LVESD,left ventricular ASL and PSL,and LVEF at weekend 3 were significantly higher in simvastatin treatment group（P〈0.05,P〈0.01）. The LVEDD, LVESD,left ventricular Ra/D,left ventricular ASL and PSL were significantly lower while the LVEF was significantly higher at weekends 2 and 3 in simvastatin treatment group than in control group（P〈0.05）. Conclusion Simvastatin can inhibit LVR in AMI patients after emergency PCI.

关 键 词：心肌梗死 心室功能 左 心室重构 超声心动描记术 多普勒 阿司匹林 血小板聚集抑制剂 斯伐他汀 

分 类 号：R542.22[医药卫生—心血管疾病]