瑞舒伐他汀不同预处理对老年STEMI患者PPCI后心肌再灌注的疗效  

Effect of Different Pre-treatment of Rosuvastatin on the Level of Myocardial Reperfusion after PPCI Surgery of Elderly STEMI Patients

作　　者：卢青[1] 丁世芳[1] 陈志楠[1] 蒋桔泉[1] 龚志刚[1] 李志刚[1] 付文波[1] 

机构地区：[1]广州军区武汉总医院心血管内科,湖北武汉430070

出　　处：《华南国防医学杂志》2016年第4期243-246,252,共5页Military Medical Journal of South China

基　　金：湖北省科技支撑计划项目(2014BCH051)

摘　　要：目的探讨术前瑞舒伐他汀不同预处理,对长期或未服用他汀药物的急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)直接经皮冠状动脉介入治疗(primary percutaneous coronary intervention,PPCI)老年患者心肌再灌注和近期疗效的影响。方法按起病前是否服用他汀类药物超过3个月,将118例首次STEMI老年患者分为长期他汀干预组(32例)、大剂量预处理组(45例)和常规剂量预处理组(41例)。比较3组患者生化指标、心肌再灌注情况、近期疗效。结果与常规剂量组比较,大剂量组和长期他汀干预组术后24 h的肌酸激酶同功酶(creatine kinase,CK-MB)、肌钙蛋白T(troponin T,TnT)、超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)和N-末端脑利钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)水平,心肌再灌注以及术后40 d左心室短轴缩短率(left ventricular fractional shortening,LVFS)和左心室射血分数(left ventricular ejection fraction,LVEF)值、再发心绞痛、心力衰竭、严重心律失常的发生均有明显改善,差异有统计学意义(P<0.05)。结论长期服用他汀药物病史患者术前常规剂量瑞舒伐他汀预处理,即可进一步提高STEMI老年患者急诊PPCI后心肌再灌注水平,保护心肌,改善近期疗效,减少严重心律失常的发生。Objective To compare the level of myocardial reperfusion and the recent clinical effects after different previous therapies of rosuvastatin on elderly patients with ST-segment elevation myocardial infarction （STEMI） under the primary percutaneous coronary intervention（PPCI）. Methods A total of 118 patients suffered from STEMI first time were randomly divided into long-term statin intervention group （n = 32）, high dose pretreatment group （n = 45） and con- ventional dose pretreatment group （n = 41） according to if the patients had disease before taking stains for more than 3 months, the case of myocardial reperfusion and major adverse cardiovascular events were compared. Results After PPCI, the biomarkers,the case of myocardial reperfusion, the values of left ventricular fraction shortening （LVFS） and left ven- tricular ejection fraction（LVEF） after operation 40 days, and the incidence of major adverse cardiovascular events in con- ventional dose pretreatment group were significantly worse than another two groups （P〈0. 05）. Conclusion Convention- al dose pretreatment with rosuvastatin for patients who long-term have statins before PPCI, which can improve the level of myocardial reperfusion, protect myocardium, improve the recent clinical effects and reduce the occurrence of serious ar- rhythmia.

关 键 词：老年人 他汀 急性ST段抬高型心肌梗死 再灌注 心功能 直接经皮冠状动脉介入治疗 

分 类 号：R96[医药卫生—药理学]