阿托伐他汀对急性ST段抬高型心肌梗死PCI术后患者血糖的影响研究  

Influence of atorvastatin on glycometabolism of patients with acute ST-segment elevation myocardial infarction of undergoing percutaneous coronary intervention

作　　者：周辉[1] 王岚峰[2] Zhou Hui;Wang Lan-feng(Department of Cardiology, Qiqihar First Machine Tool Plant Hospital, Qiqihar, Heilongjiang, 161005, China;Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, 150001, China)

机构地区：[1]齐齐哈尔第一机床厂职工医院内五科,黑龙江齐齐哈尔161005 [2]哈尔滨医科大学附属第一医院心内科,黑龙江哈尔滨150001

出　　处：《当代医学》2017年第15期13-17,共5页Contemporary Medicine

摘　　要：目的探究阿托伐他汀钙片对行急诊经皮冠状动脉支架置入术(percutaneous coronary intervention,PCI)的ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者和STEMI伴有2型糖尿病(type 2 diabetic mellitus,T2DM)患者血糖代谢的影响。方法选取哈尔滨医科大学第一临床医学院CCU病房2015年7月~2015年12月之间确诊为急性STEMI且行急诊PCI术的患者200例,通过回顾性统计分析,分成非T2DM组(158例)以及T2DM组(42例),入院后即给予阿托伐他汀钙片40 mg睡前口服,1次/d,以入院第二日清晨抽取肘静脉血化验的空腹血浆葡萄糖(fasting plasma glucose,FPG)和糖化血红蛋白A1c(Glycated hemoglobin A1c,Hb A1c)值为基线,分别于1个月和3个月后在本院门诊心梗随访诊室复查FPG与Hb A1c,然后同住院时的基线值实行对比,评估阿托伐他汀钙片对行急诊PCI术的STEMI患者血糖代谢的影响。结果服用阿托伐他汀钙片1个月后,非T2DM组患者FPG值由(6.66±2.63)mmol/L降至(5.42±1.05)mmol/L,Hb A1c由(5.56±0.37)%升至(5.61±0.40)%,服药3个月后FPG值由(5.42±1.05)mmol/L升至(5.63±1.12)mmol/L,Hb A1c由(5.61±0.40)%升至(5.74±0.51)%;T2DM组患者FPG值由(10.83±4.33)mmol/L降至(8.51±1.40)mmol/L,Hb A1c由(7.60±1.45)%升至(7.71±1.50)%,服药3个月后FPG值由(8.51±1.40)mmol/L升至(8.73±2.12)mmol/L,Hb A1c由(7.71±1.50)%升至(7.76±1.53)%,然而上述差别无显著性统计学意义。结论行急诊PCI术的STEMI及STEMI伴T2DM患者,口服中等剂量阿托伐他汀钙片3个月后空腹血糖与基线值比较有所下降,但与1个月时的空腹血糖水平比较有升高趋势。Objective To investigate the influence of atorvastatin on glycometabolism in patients with acute ST-segment elevation myocardial infarction(STEMI)or STEMI combined with type2diabetes mellitus(T2DM)of undergoing percutaneous coronary intervention(PCI).Methods Two hundred patients with STEMI were selected in CCU ward of the first Affiliated Hospital of Harbin Medical University between July2015to December2015and all of patients were performed PCI.By retrospectively analyzed,all of patients were divided into an STEMI group(n=158)and an STEMI+T2DM group(n=42).The subjects were given oral administration of atorvastatin40mg q.n.from admission.The levels of fasting plasma glucose(FPG)and glycated hemoglobin A1c(HbA1c)were determined upon admission and in follow-up examination one and three months later.Results After oral administration of atorvastatin40mg q.n.for one months,the levels of FPG and HbA1c of patients in STEMI group declined from(6.66±2.63)mmol/L to(5.42±1.05)mmol/L,increased from(5.56±0.37)%to(5.61±0.40)%,respectively;And those of patients in the STEMI+T2DM group declined from(10.83±4.33)mmol/L to(8.51±1.40)mmol/L,increased from(7.60±1.45)%to(7.71±1.50)%,respectively.For three months,the levels of FPG and HbA1c of patients in STEMI group increased from(5.42±1.05)mmol/L to(5.63±1.12)mmol/L,from(5.61±0.40)%to(5.74±0.51)%,respectively;And those of patients in the STEMI+T2DM group increased from(8.51±1.40)mmol/L to(8.73±2.12)mmol/L,increased from(7.71±1.50)%to(7.76±1.53)%,respectively.However,the changes were of no statistical significance.Conclusion For undergoing emergency PCI in patients with STEMI or STEMI combined with T2DM,oral moderate-dose atorvastatin led to FPG decline comparison with baseline after three months,but the FPG levels was increased comparison with one month.

关 键 词：阿托伐他汀钙片 急性ST段抬高型心肌梗死 经皮冠状动脉支架置入术 2型糖尿病 空腹血糖 糖化血红蛋白 

分 类 号：R542.22[医药卫生—心血管疾病]