瑞舒伐他汀对急性心肌梗死病人心功能及内皮功能的影响  

The Influence of Rosuvastatin on Cardiac Function and Endothelial Function in Patients with Acute Myocardial Infarction

作　　者：周瑜[1] 王勉[2] 

机构地区：[1]四川省崇州市人民医院,四川崇州611230 [2]四川大学华西医院

出　　处：《中西医结合心脑血管病杂志》2017年第7期826-830,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的观察瑞舒伐他汀对急性心肌梗死(AMI)病人心功能及内皮功能的影响。方法将2012年3月—2015年9月因急性心肌梗死于崇州市人民医院就诊的60例病人纳入研究,并随机分为治疗组与对照组,各30例。所有病人均依据指南采取常规治疗,对照组病人加用阿托伐他汀治疗,治疗组联合瑞舒伐他汀治疗,28 d为1个疗程。观察两组治疗前后脑钠肽(BNP)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左室射血分数(LVEF)等心功能指标及超敏C反应蛋白(hs-CRP)的改善情况;观察两组一氧化氮(NO)、内皮素(ET)改善情况;行超声检查比较硝酸甘油介导的血管舒张反应(NMD)及计算血流介导的血管舒张反应(FMD)等血管内皮功能指标改善情况;比较病人心电图QRS积分、梗死面积及治疗开始28 d内并发症发生情况。结果治疗后,两组病人BNP、hs-CRP、LVEDD、LVESD、ET水平均降低,FMD、NMD、LVEF则升高,但治疗组改善均更显著,差异有统计学意义(P<0.05);两组病人心电图QRS积分均降低,但治疗组改善更显著,梗死面积更小,且再梗死、严重心律失常、心衰等并发症总发生率更低,差异有统计学意义(P<0.05)。结论瑞舒伐他治疗AMI病人疗效显著,可更好地保护心脏功能及内皮功能,改善预后,优于常规治疗。Objoctive To observe the effects of rosuvastatin on cardiac function and endothelial function in patients with acute myocar-dial infarction （AMI） .Methods Sixty patients with AMI were randomly divided into two groups： control group （ n = 30） treated with routine treatment plus atorvastatin, and treatment group （n = 30） treated with routine treatment plus rosuvastatin for 28 days.The levels of brain natriuretic peptide （BNP）,high sensitivity C reactive protein （hs CR P ）,nitric oxide （NO）,endothelin （ET） were detected.The left ventricular end diastolic diameter （LVEDD）,left ventricular end systolic diameter （LVESD）,left ventricular ejection fraction （LVEF） were observed.The improvement of nitrog lycerinme diated dilation （NMD） and the flow mediated dilation （FMD） were compared.The infarct size,the electrocardiogram （ECG） QRS integral and complications were observed.Results After treat-ment,the levels of BNP,hs- CRP,-VEDD,LVESD,ET were decreased while the levels of FMD,NMD,LVEF were increased in two groups,the improvement was more significant in treatment group （ P 〈0.05） .The scores of ECG QRS were lower in two groups, which was lower in treatment group than that in control group （ P 〈0.05）.The infarct size and the incidence of reinfarction, severe arrhythmia, heart failure were lower in treatment group than that in control group （ P〈0.05） .Conclusion Rosuvastatin can improve cardiac function protection and endothelial function in patients with AMI.

关 键 词：急性心肌梗死 瑞舒伐他汀 心功能保护 内皮功能 

分 类 号：R542.22[医药卫生—心血管疾病]