高血压合并STEMI患者阿托伐他汀强化方案临床效果及其对血压、血脂、心功能及Lp-PLA2的影响  

Curative Efficacy of Atorvastatin Enhanced Regimen in Treatment of STEMI and its Effects on Lipoprotein Phospholipase A2 Levels

作　　者：周菲[1] 张敬文[1] ZHOU Fei;ZHANG Jingwen(Department of Cardiovasology, Hainan People＇s Hospital, Haikou 570311 ,China)

机构地区：[1]海南省人民医院心血管内科,海口570311

出　　处：《解放军预防医学杂志》2018年第9期1097-1100,1104,共5页Journal of Preventive Medicine of Chinese People's Liberation Army

基　　金：海南省自然科学基金面上项目(No.20168293)

摘　　要：目的探讨高血压合并ST段抬高急性心肌梗死(STEMI)患者阿托伐他汀强化方案临床效果及其对Lp-PLA2的影响。方法选择2014年5月-2016年5月我院接诊的96例高血压并发STEMI患者,采用随机数字表法分为观察组(n=48)和对照组(n=48),对照组给予常规治疗,观察组在此基础上联合阿托伐他汀强化方案。比较两组高血压疗效、心电图疗效及治疗前后血压、血脂、心功能及Lp-PLA2水平的变化。结果观察组高血压疗效总有效率为91.67%,明显高于对照组的72.92%(P<0.05),观察组心电图疗效总有效率为89.58%,明显高于对照组的68.75%;治疗后,两组收缩压(SBP)、舒张压(DBP)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、三酰甘油(TG)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室射血分数(LVEF)、一氧化氮(CO)、心脏指数(CI)、Lp-PLA2水平较治疗前均显著改善(P<0.05);观察组SBP、DBP均明显比对照组低[(125.79±12.14)mm Hg vs(134.81±13.05)mm Hg,(81.45±7.12)mm Hg vs(88.02±7.84)mm Hg](P<0.05),观察组HDL-L、LDL-L、TC、TG均明显优于对照组[(1.43±0.21)mmol/L vs(1.17±0.16)mmol/L,(2.74±0.45)mmol/L vs(3.57±0.62)mmol/L,(4.19±0.42)mmol/L vs(5.07±0.73)mmol/L,(1.21±0.20)mmol/L vs(1.78±0.28)mmol/L](P<0.05),观察组LVEDD、LVESD、LVEF、CO、CI均明显优于对照组[(50.83±5.10)mm vs(58.21±5.86)mm,(39.85±3.63)mm vs(45.84±4.52)mm,(49.82±5.17)%vs(41.03±4.59)%,(3.87±0.62)L/min vs(3.29±0.50)L/min,(2.89±0.33)L/m2vs(2.29±0.28)L/m2](P<0.05),观察组Lp-PLA2水平明显比对照组低[(127.59±21.36)ng/ml vs(169.84±24.94)ng/ml](P<0.05)。结论在高血压并发STEMI患者中应用阿托伐他汀强化方案降压、降脂效果显著,且有助于改善心功能,其内在机制可能和降低Lp-PLA2的表达相关。Objective To study the curative efficacy of the atorvastatin enhanced regimen in the treatment of ST segment elevation acute myocardial infarction（ STEMI） and its effects on lipoprotein phospholipase A2（ Lp-PLA2） levels.Methods Eighty patients of hypertension with STEMI who were treated in our hospital between May 2014 and May 2016 were selected. Using the random number table,those patients were divided into the observation group（ n = 48） and the control group（ n = 48）. The control group received routine treatment while the observation group was additionally treated with the atorvastatin enhanced regimen. The curative effect against hypertension,effect on electrocardiograms and the changes of blood pressure,blood lipid,heart function and Lp-PLA2 levels were compared between the two groups before and after treatment.Results After treatment,the total effective rate of hypertension in the observation group was 91.67%,which was higher than 72.92% in the control group（ P〈0.05）. The total effective rate of electrocardiograms in the observation group was 89.58%,which was higher than 68.75% in the control group（ P〈0.05）.The systolic blood pressure（ SBP） and diastolic pressure（ DBP）,high density lipoprotein cholesterol（ HDL-C）,low density lipoprotein cholesterol（ LDL-C）,total cholesterol（ TC）,triacylglycerol（ TG）,left ventricular end diastolic diameter（ LVEDD）,left ventricular end systolic diameter（ LVESD）,left ventricular ejection fraction（ LVEF）,nitric oxide（ CO） and cardiac index（ CI）,Lp-PLA2 levels in the two groups were significantly improved after treatment（ P〈0.05）. The SBP and DBP in the observation group were significantly lower than those of the control group[（ 125.79±12.14） mm Hg vs（ 134.81±13.05） mm Hg,（ 81.45±7.12） mm Hg vs（ 88.02±7.84） mm Hg]（ P〈0.05）. HDL-L,LDL-L,TC and TG in the observation group were significantly better than those of the control group[（ 1.43±0.21） mmol/L vs（ 1.17±0.16） mmol/L

关 键 词：高血压 ST段抬高急性心肌梗死 阿托伐他汀 脂蛋白磷脂酶A2 

分 类 号：R544.1[医药卫生—心血管疾病]