急性非ST段抬高型心肌梗死PCI围术期强化阿托伐他汀治疗对改善患者术中心肌灌注以及近期预后的临床研究  

The Effects of Perioperative High-dose Atorvastatin on Myocardial Perfusion during Procedure and Recent Prognosis in Patients with non ST-segment Elevation Myocardial Infarction

作　　者：章慧慧[1,2,3] 黄抒伟[1] 林冬铭[1] 徐长福[1] 

机构地区：[1]浙江中医药大学附属第二医院心内科,310009 [2]浙江中医药大学 [3]杭州市余杭区第一人民医院心内科

出　　处：《心电与循环》2013年第4期269-272,共4页Journal of Electrocardiology and Circulation

基　　金：浙江省医学会临床科研基金项目(2009ZYC17)

摘　　要：目的研究急性非ST段抬高型心肌梗死患者在行经皮冠状动脉介入治疗(PCI)围术期应用大剂量阿托伐他汀对改善术中心肌灌注及对术后30d内不良心血管事件(MACE)的影响。方法 81例急性非ST段抬高性心肌梗死患者随机分为观察组(n=41)和对照组(n=40)。观察组顿服阿托伐他汀80mg,之后服用阿托伐他汀40mg/d 1周,1周后改为20mg/d。对照组给予阿托伐他汀20mg/d。PCI术中观察TIMI血流分级,记录校正的TIMI计帧值(CTFC)。随访观察术后30d内MACE发生率。结果(1)术中TIMI血流等级两组间无统计学差异(P>0.05)。(2)两组间CTFC差异有统计学意义(27.3±6.9、31.5±7.3,P<0.05)。(3)两组间30d内发生MACE差异无统计学意义(P>0.05)。结论 NSTEMI患者PCI围术期负荷量阿托伐他汀强化治疗可以改善患者PCI术中冠状动脉血流灌注,减少无复流的发生率。Objective To study the effects of perioperetive high-dose atorvastatin on myocardial perfusion during percutaneous coronary intervention （PCI） and recent prognosis in patients with non ST-segment elevation myocardial infarction （NSTEMI）. Methods 81 patients with NSTEMI were randomized divided into experimental group （n=41） and control group （n=40）.The experimental group was treated with atorvastatin 80mg once and 40mg per day for a week, then 20mg per day. The control group was treated with atorvastatin 20mg per day. TIMI blood flow grade and corrected TIMI frame count were documented during PCI. Main adverse cardiovascular events during follow-up of 30 days were analyzed. Results Corrected TIMI frame count was significantly lower in experimental group than in control group （P〈0.05）. TIMI blood flow grade and adverse cardiovascular events were not significantly different between two groups（P 〉0.05）. Conclusion Perioperetive high-dose atorvastatin treatment can improve coronary flow during PCI in patients with NSTEMI.

关 键 词：阿托伐他汀 非ST段抬高型心肌梗死 经皮冠状动脉介入术 无复流 心血管事件 

分 类 号：R542.22[医药卫生—心血管疾病]