大剂量阿托伐他汀对应激性高血糖急性心肌梗死急诊PCI术后的影响  

Efficacy of Large-dose Atorvastatin on Emergency PCI of Stress Gyperglycemia Patients with A-cute Myocardial Infarction

作　　者：朱洪松[1] 林兆奋[1] 

机构地区：[1]第二军医大学附属长征医院急救科,上海201199

出　　处：《医学临床研究》2017年第2期334-336,共3页Journal of Clinical Research

摘　　要：【目的】探讨大剂量阿托伐他汀对应激性高血糖（SHG）急性心肌梗死（AMI）患者急诊PCI术近期疗效及心血管事件的影响。【方法】68例AMI伴SHG患者随机分为观察组与对照组,各34例,均接受常规抗血小板药物及急诊PCI治疗,此外观察组给予大剂量阿托伐他汀（术前80 mg/d,术后40 mg/d）口服,对照组采取常规剂量（20 mg/d）干预,比较两组术后心肌灌注及心功能指标,同时记录两组术后d28不良心血管事件发生率。【结果】术后心肌灌注方面,两组术后肌酸激酶同工酶（CK-MB）峰值、ST段回落良好（回落≥50%）率、心肌灌注良好率比较差异均无显著性（P＞0.05）;心功能方面,观察组术后7 d左室射血分数（LVEF）显著高于对照组（P＜0.05）;随访28 d观察组心力衰竭发生率8.82%显著低于对照组的29.41%（P＜0.05）,两组严重心律失常、心绞痛、再发心肌梗死、死亡发生率比较差异无显著性（P＞0.05）。【结论】相比常规剂量,大剂量阿托伐他汀在提高AMI伴SHG患者急诊PCI术后7 d LVEF、降低28 d心力衰竭发生率上有明显优势。【Objective】 To explore effects of large-dose atorvastatin on short term efficacy of emergency PCI and cardiovascular events on patients with stress hyperglycemia （SHG） acute myocardial infarction （AMI）.【Methods】Sixty-eight cases of AMI with SHG were randomly divided into observation group and control group, each with 34 cases. All patients received conventional antiplatelet drugs and emergency PCI treatment. In addition, the observation group was given high dose oral atorvastatin （80mg/d, 40mg/d）, while the control group was treated with conventional dose （20mg/d）.The myocardial perfusion and cardiac function were compared between the two groups, and the incidence of adverse cardiovascular events in 28d was recorded in the two groups.【Results】There was no significant difference in postoperative CK-MB peak, ST segment resolution good （drop≥50%） rate, myocardial perfusion good rate of the two groups in postoperative myocardial perfusion （P〉0.05）; postoperative 7d LVEF in the observation group was significantly higher than that in the control group （P〈0.05）; the incidence of heart failure of the observation group 8.82% was significantly lower than that of the control group （29.41%） in 28d follow-up （P〈0.05）, there was no significant difference in incidence of severe arrhythmia, stenocardia, recurrent myocardial infarction and death in the two groups （P〉0.05）. 【Conclusion】 Compared with routine dose, large dose atorvastatin has obvious advantages in increasing LVEF 7d after emergency PCI and reducing incidence of 28d heart failure in AMI patients with SHG.

关 键 词：庚酸类/治疗应用 吡咯类/治疗应用 高血糖症/并发症 心肌梗死/病因学 急性 病 血管成形术 经腔 经皮冠状动脉 

分 类 号：R542.22[医药卫生—心血管疾病]