急性心肌梗死患者急诊冠脉介入术前高剂量瑞舒伐他汀治疗对心肌灌注和预后的影响  

Effect of high-dose rosuvastatin treatment of patients with acute myocar-dial infarction before emergency coronary intervention on myocardial perfusion and prognosis

作　　者：程国杰[1] 王金波[1] 曹树军[1] 胡硕强[1] 王文斌[1] 郭丽敏[1] 

机构地区：[1]首都医科大学大兴医院心内科,北京102600

出　　处：《中国医药导报》2015年第30期116-119,共4页China Medical Herald

基　　金：北京市大兴区科技计划课题项目(1362-1)

摘　　要：目的探讨急性心肌梗死患者急诊经皮冠脉介入治疗（PCI）术前高剂量瑞舒伐他汀对心肌灌注和预后的影响。方法选择2013年1月～2014年12月在首都医科大学大兴医院就诊的急性ST段抬高型心肌梗死患者145例为研究对象，根据急诊PCI术前是否服用高剂量瑞舒伐他汀将患者分为常规治疗组（70例）和高剂量瑞舒伐他汀组（75例）。在急诊PCI术后两组患者均给予冠心病二级预防治疗，其中瑞舒伐他汀钙均给予10mg，每晚1次。高剂量瑞舒伐他汀组在此基础上给予高剂量瑞舒伐他汀20mg顿服。采用心肌灌注呈色分级（MBG）评价心肌灌注情况。并对患者进行随访，了解患者主要不良心脏事件（包括再发心肌梗死、心力衰竭、心源性死亡）的发生情况。结果高剂量瑞舒伐他汀组患者急诊PCI术后MBG3级患者明显多于常规治疗组（53．3％比30．0％）（P〈0．05）。而MBG 0～1级患者少于常规治疗组（12．0％比21．4％）（P〈0．05）。高剂量瑞舒伐他汀组患者随访期间主要不良心脏事件的发生率低于常规治疗组（9．3％tL22．9％）（P〈0．05）。结论急性心肌梗死患者急诊PCI术前高剂量瑞舒伐他汀治疗可以改善患者的心肌灌注和预后。Objective To investigate effects of high-dose rosuvastatin treatment of patients with acute myocardial in- farction before emergency percutaneous coronary intervention on myocardial perfusion and prognosis. Methods 145 pa- tients with acute ST segment elevation myocardial infarction hospitalized in Daxing Hospital of the Capital Medical University from January 2013 to December 2014 were selected. According to whether taking high-dose rosuvastatain before emergency PCI, they were divided into conventional therapy group （70 cases） and high dose rosuvastatain group （75 cases）. All patients were given secondary prevention of coronary heart disease treatment after emergency PCI, and rosuvastatain was registered 10 mg per night. On this basis, on high dose rosuvastatain group. Myocardial perfusion was high-dose rosuvastatain was administered 20 mg at draught evaluated by myocardial perfusion blush grade （MBG）. And patients were followed up. The main adverse cardiac events including recurrent myocardial infarction, heart failure and cardiac death were recorded. Results The proportion of MBG 3 patients after primary PCI was higher in high-dose ro- suvastatin group than that in conventional therapy group （53.3% vs 30.0%）, （P 〈 0.05）. The proportion of MBG 0-1 patients was lower in high-dose rosuvastatin group （12.0% vs 21.4%）, （P 〈 0.05）. The incidence of main adverse car- diac events was lower in high-dose rosuvastatin group than that in conventional therapy group （9.3.% vs 22.9%）, （P 〈 0.05）. Conclusion High-dose rasuvastatin treatment of patients with acute myocardial infarction before emergency PCI can improve myocardial perfusion and prognosis.

关 键 词：急性心肌梗死 瑞舒伐他汀 心肌灌注 预后 

分 类 号：R542.22[医药卫生—心血管疾病]