短期强化他汀治疗ST段抬高型心肌梗死的效果  

Effect of short-term intensive statin therapy on ST-segment elevation myocardial infarction

作　　者：李庚 张国新[1] 凡华 李恒涛 汤卫兵 LI Geng;ZHANG Guoxin;FAN Hua;LI Hengtao;TANG Weibing(Department of Emergency,Suzhou Jiulong Hospital,School of Medicine,Shanghai Jiao Tong University,Suzhou 215127,China)

机构地区：[1]上海交通大学医学院苏州九龙医院急诊科,江苏苏州215127

出　　处：《长春中医药大学学报》2023年第10期1138-1141,共4页Journal of Changchun University of Chinese Medicine

基　　金：2018年度苏州市科技发展计划(SYSD2018064)。

摘　　要：目的分析短期强化他汀治疗对ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术后心肌损伤标志物、血脂水平及主要不良心血管事件(MACE)风险的影响。方法选择2019年3月-2022年3月上海交通大学医学院苏州九龙医院急诊科收治的STEMI患者80例,随机数字表法分为对照组与观察组,各40例。2组均接受PCI术治疗,对照组接受他汀治疗(瑞舒伐他汀钙片,每次10 mg,每天1次),观察组接受短期强化他汀治疗(瑞舒伐他汀钙片,每次20 mg,每天1次),均用药8周。分析2组治疗前后血清心肌损伤标志物、血脂指标、炎症反应指标水平,治疗期间MACE风险。结果与治疗前比较,治疗后2组血清肌钙蛋白I(TnI)、肌酸激酶同工酶(CK-MB)、氨基酸N端脑钠肽(NT-proBNP)、肌红蛋白(Myo)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、三酰甘油(TG)、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)水平下降,且观察组更低(P<0.05)。治疗后2组血清高密度脂蛋白胆固醇(HDL-C)水平升高,且观察组更高(P<0.05)。治疗期间,观察组MACE发生率低于对照组(P<0.05)。结论短期强化他汀治疗可降低STEMI患者PCI术后血清心肌损伤标志物,调节血脂代谢,降低机体炎症反应与MACE风险。Objective To analyze the effect of short-term intensive statin therapy on the levels of cardiac injury markers and blood lipid,and risk of major adverse cardiovascular events(MACE)in patients with ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods From March 2019 to March 2022,80 patients with STEMI admitted to Department of Emergency,Suzhou Jiulong Hospital,School of Medicine,Shanghai Jiaotong University were selected and divided into the control group and the observation group according to random number table method,with 40 cases in each group.Both groups received PCI treatment,the control group received statin therapy(rosuvastatin calcium tablets 10 mg/time,once/d),and the observation group received short-term intensive statin therapy(rosuvastatin calcium tablets 20 mg/time,once/d)for 8 weeks.The serum levels of cardiac injury markers,blood lipid indexes and inflammatory response indexes before treatment and after treatment,and the risk of MACE during treatment in the two groups were analyzed.Results Compared with before treatment,the levels of serum troponin I(TnI),creatine kinase isoenzyme MB(CK-MB),amino N-terminal brain natriuretic peptide(NTproBNP),myoglobin(Myo),low density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triacylglycerol(TG),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and hypersensitive C-reactive protein(hs-CRP)in the two groups decreased,and the observation group was lower than the control group(P<0.05).After treatment,the serum levels of high-density lipoprotein cholesterol(HDL-C)in the two groups increased,and the observation group was higher than the control group(P<0.05).During treatment incidence of MACE in the observation group was lower than that in the control group(P<0.05).Conclusion Short-term intensive statin therapy can reduce the levels of serum markers of myocardial injury in patients with STEMI after PCI,regulate blood lipid metabolism,recuce the body's inflammatory response and the risk of MACE.

关 键 词：急性ST段抬高型心肌梗死 经皮冠状动脉介入治疗 瑞舒伐他汀 强化他汀治疗 心肌损伤 血脂 

分 类 号：R542.2[医药卫生—心血管疾病]