单次负荷剂量瑞舒伐他汀对STEMI患者尿酸及冠脉血流的影响  

Effects of single loading dose of rosuvastatin on uric acid and coronary blood flow in patients with acute ST-segment elevation myocardial infarction

作　　者：严凌[1] 朱春甲[1] 周杰[1] 汪坤[1] 李必龙[1] 

机构地区：[1]铜陵市人民医院心血管内科,安徽铜陵244000

出　　处：《皖南医学院学报》2016年第5期457-459,463,共4页Journal of Wannan Medical College

摘　　要：目的:探讨经皮冠状动脉介入治疗(PCI)术前单次负荷剂量瑞舒伐他汀对急性ST段抬高型心肌梗死(STEMI)患者冠脉血流及尿酸的影响。方法:入选在发病后12 h内行PCI治疗的STEMI患者90例,随机分为两组:对照组44例,PCI术后口服瑞舒伐他汀10 mg/日;负荷治疗组46例,PCI术前口服瑞舒伐他汀20 mg,术后继续服用瑞舒伐他汀10 mg/日。并根据初始血清尿酸水平将两组再各分为正常尿酸组及高尿酸血症组。观察用药前后两组尿酸水平、PCI后冠状动脉血流的变化。结果:负荷剂量组与对照组相比,高尿酸血症患者尿酸下降差异有统计学意义(P<0.05)。负荷剂量组与对照组无复流发生率(27.2%vs.10.8%),差异有统计学意义(P<0.05)。多因素Logistic回归分析显示再灌注时间、术前尿酸水平与冠脉无复流发生正相关,而服用瑞舒伐他汀与冠脉无复流发生负相关。结论:PCI术前单次负荷剂量瑞舒伐他汀可降低合并高尿酸血症的STEMI患者血尿酸水平,可减少PCI术中无复流发生。Objective： To investigate the effects of single loading dose of rosuvastatin on uric acid and coronary blood flow in patients with myocardial infarction presenting with acute ST-segment elevation（ STEMI）. Methods： Ninety patients with STEMI received percutaneous coronary intervention（ PCI）treatment in 12 h were included and randomly allocated to control group（ oral rosuvastatin in dose of 10 mg / day following PCI,n = 44） and single loading dose group（ oral rosuvastatin in dose of 20 mg / day before therapy and following dose of 10 mg / day after PCI,n = 46）.Then the two groups were subgrouped into normal level and high level groups by the uric acid levels initially measured,and observed for the changes in coronary blood flow after PCI and uric acid levels before and after medication.Results： By comparison of the single loading dose group with the control group,the serum uric acid level was significantly reduced in patients with high levels（ P〈 0. 05）. The incidence of ＂no-reflow＂was also different in the loading dose group and the control group（ 27.2% vs.10.8%,P〈0.05）.Multivariate Logistic regression analysis showed that the time of reperfusion and preoperative uric acid level were positively correlated with complication of＂no-reflow＂and negatively with＂no-reflow＂occurrence following loading dose of rosuvastatin.Conclusion： Single loading dose of rosuvastatin can reduce hyperuricemia and the incidence of＂no-reflow＂in patients with STEMI after PCI.

关 键 词：瑞舒伐他汀 尿酸 无复流 

分 类 号：R542.22[医药卫生—心血管疾病]