他汀强化治疗对行急诊经皮冠状动脉介入术患者的中期影响  

Mid-term effect of intensive statin therapy on patients undergoing emergency percutaneous coronary intervention

作　　者：严子君[1] 朱政斌[1] 顾圣佳 张瑞岩[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院心脏科,200025 [2]上海交通大学医学院附属瑞金医院放射科,200025

出　　处：《国际心血管病杂志》2017年第6期357-359,364,共4页International Journal of Cardiovascular Disease

摘　　要：目的:应用无创性心脏影像学技术评估他汀强化治疗对行急诊经皮冠状动脉介入术(PCI)的急性ST段抬高型心肌梗死(STEMI)患者中期预后的影响。方法:入选因STEMI于瑞金医院行急诊PCI治疗的患者,随机分为他汀强化组(n=24)和常规治疗组(n=24)。术后6个月时行超声心动图和心脏磁共振检查。应用三维超声心动图斑点追踪成像(3-dimensional echocardiography speckle tracking imaging,3DSTI)和四维左室容积定量分析(4-dimensional left ventricular volume quantitative analysis,4DLVQ)半自动测量左室射血分数(LVEF),获取左心室整体纵向峰值应变(global longitudinal peak strain,GLPS)、整体环向峰值应变(global circumferential peak strain,GCPS)、整体径向峰值应变(global radial peak strain,GRPS)和整体面积峰值应变(global area peak strain,GAPS)。心脏磁共振检查以Argus 4D软件处理,半自动法测定LVEF和梗死面积百分比。比较两组患者基线与PCI术后6个月时血脂指标和影像学参数。结果:他汀强化组与常规治疗组在年龄、性别、生化指标、合并症及前壁心肌梗死比例等方面的差异均无统计学意义。PCI术后6个月时,与常规治疗组相比,他汀强化组GAPS、GLPS绝对值明显升高,梗死面积百分比明显减小(P均<0.05);两组间血脂、LVEF、GCPS、GRPS无统计学差异。结论:他汀强化治疗对行急诊PCI的STEMI患者的中期预后有改善作用。Objective：To investigate the effect of intensive statin therapy on the mid-term prognosis of patients with acute ST segment elevation myocardial infarction （STEMI）who undergo emergency percutaneous coronary intervention （PCI） by non-invasive cardiac imaging parameters. Methods： We enrolled patients with STEMI who underwent emergency PCI in our hospital. They were randomly divided into intensive statin group （n = 24） and common statin group （n = 24）. Eehocardiography and cardiac magnetic resonance were performed 6 months after the operation. Three-dimensional eehocardiography speckle tracking imaging （3DSTI） and four-dimensional left ventricular volume quantitative analysis （4DLVQ） were applied to semiautomatic measurement of left ventricular ejection fraction （LVEF）, left ventricular global longitudinal peak strain （GLPS）, global circumferential peak strain （GCPS）, global radial peak strain （GRPS）, and global area peak strain （GAPS）. The cardiac magnetic resonance images were processed by Argus 4D software. LVEF and the percentage of infarct size were measured by semiautomatic method. Blood lipid and cardiac imaging parameters were compared between the two groups at baseline and 6 months after PCI. Results： There was no significant difference in the age, sex, biochemical parameters, complicaions and the proportion of anterior wall myocardial infarction between the two groups. At 6 months follow-up, there was no significant difference in blood lipid and LVEF between the two groups. The absolute values of GAPS and GLPS in intensive statin group were significantly higher than those in common statin group, while the infarct size was significantly smaller （all P〈0. 05）. There was no significant difference in GCPS and GRPS between the two groups. Conclusion： Intensive statin therapy could improve the mid-term prognosis of patients with STEMI who undergo emergency PCI.

关 键 词：他汀 急性ST段抬高型心肌梗死 三维超声心动图斑点追踪成像 心脏磁共振 预后 

分 类 号：R542.22[医药卫生—心血管疾病]