术前强化阿托伐他汀治疗对急性ST段抬高型心肌梗死患者的疗效探讨  

Effect of Intensive Atorvastatin Therapy on Acute STEMI before PCI

作　　者：赵明[1] 张军[1] 张巍[1] 贾国伟[1] 孙荣国[1] 马博聪[1] 杨建国[1] 

机构地区：[1]沧州市中心医院心内科,沧州061001

出　　处：《中国医药导刊》2014年第7期1153-1154,1156,共3页Chinese Journal of Medicinal Guide

摘　　要：目的:探讨术前强化阿托伐他汀治疗对行急诊经皮冠状动脉介入治疗(PCI)的ST段抬高型心肌梗死(STEMI)患者的疗效。方法:因STEMI就诊于我院接受急诊PCI治疗的发病6h内的患者102例(男性62例,女性40例)。根据术前即刻顿服阿托伐他汀剂量的不同将该102例患者分为两组,分别为对照组(A组,20mg)52例,强化组(B组,80mg)50例。分别于PCI治疗前即刻、再灌注后12h,24h及72h测定血清胎盘生长因子(PlGF)及超敏C反应蛋白(hs-CRP)水平;描记术前及术后1h的心电图,计算单导联ST段下降幅度(single-lead STR),对术后造影结果进行TIMI心肌灌注分级(TMPG)。结果:(1)B组中,Single-lead STR≥50%及TMPG 2/3级的比例高于A组(P<0.05)。(2)PCI术后,两组PlGF和hs-CRP水平较术前升高,术后24h较12h仍升高,而术后72h较24h有所回落(P<0.05)。(3)与A组相比,B组在PCI前及术后12h,PlGF和hs-CRP水平没有差异(P>0.05),而术后24h及72h B组PlGF和hs-CRP水平显著降低(P<0.05)。结论:对于行急诊PCI的STEMI患者,术前强化阿托伐他汀治疗能更进一步减少PlGF和hs-CRP的释放,更好地抑制炎症反应,改善心肌组织灌注。Objective： To investigate the effect of intensive atorvastatin therapy on acute ST-segment elevation myocardial infarction（STEMI） before emergency percutaneous coronary intervention（PCI）. Methods：102 patients with STEMI suffered within 6 hours took emergency PCI treatment came from Cangzhou Center Hospital（62 males and 40 females）. According to atorvastatin dose took before PCI, this 102 patients were divided into two groups：the contral group （A group,20mg,n=52） and the intensive group （B group,80mg,n=50）. The levels of serum placental growth factor（PlGF） and high-sensitivity C-reactive protein （hs-CRP） were detected at a moment before PCI treatment, 12h,24h and 72h after PCI. We recorded the preoperative and postoperative 1h ECG,and calculated single-lead STR. We described TMPG classiifcation of patients in accordance with the results of the image of Coronary angiography after PCI. Results：（1） The proportion of single-lead STR≥50% and TMPG2/3 in B group was higher than A group（P〈0.05）. （2）In two groups ,PlGF and hs-CRP levels were higher after PCI than before PCI, which were higher in 24 hours after PCI than 12 hours after PCI, and 72 hours was lower than 24 hours（P〈0.05）. （3）Compared with Agroup, PlGF and hs-CRP levels had no difference in B group before PCI and after PCI 12h（P〉0.05）.But they were lower after PCI 24h and 72h in B group（P〈0.05）.Conclusions：The intensive atorvastatin therapy could reduce the levels of PlGF and hs-CRP, inhibit inlfammatory response better,and improve myocardial reperfusion better on acute STEMI patients before emergency PCI.

关 键 词：阿托伐他汀 急性ST段抬高型心肌梗死 胎盘生长因子 超敏C反应蛋白 

分 类 号：R542.22[医药卫生—心血管疾病]