不同剂量瑞舒伐他汀对急性ST段抬高型心肌梗死急诊介入治疗患者临床疗效的影响

不同剂量瑞舒伐他汀对急性ST段抬高型心肌梗死急诊介入治
疗患者临床疗效的影响
孟庆槐;李阳
【期刊名称】《广西医科大学学报》
【年(卷),期】2018(35)1
【摘要】目的:探讨不同剂量瑞舒伐他汀对急性ST段抬高型心肌梗死(STEMI)急诊介入治疗(PCI)患者临床疗效的影响.方法:180例STEMI患者按照随机数字表法分为观察组和对照组,每组90例.所有患者均行急诊PCI治疗,观察组分别于术前、术后口服瑞舒伐他汀20 mg,对照组术前、术后口服瑞舒伐他汀10 mg.比较两组患者治疗前和治疗7d后总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、血肌酐(Cr)、肌酸激酶MB (CK-MB)、肌钙蛋白I(cTnI)、脑钠肽(BNP)水平,同时观察前降支(LAD)、回旋支(LCX)、右冠状动脉(RCA)灌注情况及心肌梗死溶栓试验(TIMI)效果.比较两组治疗后的左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)及不良反应发生率.结果:治疗后,两组TC、TG、LDL-C均降低,HDL-C、Cr均升高,且观察组治疗后TC、TG、LDL-C及Cr低于对照组,HDL-C 高于对照组,差异均有统计学意义(均P＜0.05);两组LAD、LCX、RCA比较,差异均无统计学意义(均P＞0.05);观察组TIMI分级2级比例低于对照组(P＜0.05),3级比例高于对照组(P＜0.05):两组CK-MB、cTnI及BNP水平均升高(均P＜0.05),且观察组CK-MB、cTnI及BNP水平均低于对照组(均P＜0.05).治疗30 d后,两组LVEF均升高,LVEDD降低,并且观察组LVEF水平高于对照组,LVEDD低于对照组,差异具有统计学意义(P＜0.05).两组在治疗期间均未出现严重的不良反应.结论:较高剂量瑞舒伐他汀可以有效增加STEMI患者急诊PCI心肌组织灌注,降低STEMI
程度,减少心肌损伤,提高心肌功能.%Objective:To investigate the effect of different doses of rosuvastatin in patients with acute ST-segmert elevation myocardial infarction (STEMI) who underwent percutaneous coronary intervention (PCI).Methods:180 patients with STEMI undergoing PCI were selected and randomly divided into an observation group and a control group,with 90 cases in each group.The patients in the observation group were treated with 20 mg rosuvastatin before and after PCI,and those in the control group were treated with 10 mg rosuvastatin before and after PCI.The levels of total cholesterol (TC),triglyceride (TG),low density lipoprotein (LDL-C),high density lipoprotein (HDL-C),creatinine (Cr),creatine kinase-MB (CK-MB),troponin I (cTnI),brain natriuretic peptide (BNP) were measured before and 7 days after PCI.Anterior descending branch (LAD),left cyclotron (LCX),and right coronary artery (RCA) perfusion were assessed.The clinical effect,thrombolysis in myocardial infarction (TIMI) trial and the incidence of adverse events were observed and compared between the two groups.Results:After treatment,the levels of TC,TG,LDL-C,CK-MB,cTnI and BNP were decreased,while the HDL-C and Cr levels were increased in the observation group,compared with the control group (P＜0.05).No significant differences between groups were observed for the LAD,LCX and RCA perfusion (P＞ 0.05).Lower percentage of patients with TIMI grade 2,ard higher percentage of TIMI grades 3 were found in the observation group (P＞0.05).30 days after treatment,the left ventricular ejection fraction (LVEF) was higher,and the left ventricular diastolic endoscopy (LVEDD) was lower in the observation group than those in the
control group.No severe adverse events were noted in both groups during therapy.Conclusion:Higher dose of rosuvastatin could effectively promote myocardial perfusion in STEMI patients undergoing PCI,reduce myocardial injury and improve cardiac function.
【总页数】4页(P53-56)
【作者】孟庆槐;李阳
【作者单位】延安大学咸阳医院心内科,咸阳 712000;延安大学咸阳医院心内科,咸阳 712000
【正文语种】中文
【中图分类】R542.22
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