文章摘要
黄学莲,温元善,鲍巧玲,童世君,孙宁玲.术前负荷剂量阿托伐他汀对STEMI急诊PCI患者的Hs-CRP、BNP水平及心功能影响[J].,2017,17(34):6670-6673
术前负荷剂量阿托伐他汀对STEMI急诊PCI患者的Hs-CRP、BNP水平及心功能影响
Effects of Preoperative Loading Dose of Atorvastatin on Serum Hs-CRP and BNP Levels and Cardiac Function of Patients with STEMI Emergency PCI
投稿时间:2017-03-12  修订日期:2017-03-30
DOI:10.13241/j.cnki.pmb.2017.34.014
中文关键词: 负荷剂量  阿托伐他汀  ST段抬高型心肌梗死  经皮冠状动脉介入  高敏C反应蛋白  B型脑钠肽
英文关键词: Loading dose  Atorvastatin  STEMI  PCI  Hs-CRP  BNP  Cardiac function
基金项目:青海省自然科学基金项目(Y2008C45);西宁市科技局立项项目(2014-k-08)
作者单位
黄学莲 西宁市第一人民医院 心血管内科 青海 西宁 810000 
温元善 西宁市第一人民医院 心血管内科 青海 西宁 810000 
鲍巧玲 青海省心脑血管病专科医院 心内科 青海 西宁 810000 
童世君 青海大学附属医院 急诊内科 青海 西宁 810001 
孙宁玲 北京大学人民医院 心内科 北京 100044 
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中文摘要:
      摘要 目的:研究手术前负荷剂量阿托伐他汀对ST段抬高型心肌梗死(STEMI)急诊经皮冠状动脉介入(PCI)患者的高敏C反应蛋白(Hs-CRP)、血浆脑钠肽(BNP)水平及心功能的影响。方法:选取我院2014年9月到2016年4月间收治的ST段抬高型心肌梗死(STEMI)患者96例,均行急诊经冠状动脉介入术(PCI),采用随机数字法将其分为对照组和观察组,每组各48例。观察组患者术前口服阿托伐他汀80 mg,术后口服阿托伐他汀40 mg/d;对照组患者仅术后口服阿托伐他汀40 mg/d。比较两组患者术后灌注情况、血清高敏C反应蛋白(hs-CRP)、B型脑钠肽(BNP)、基质金属蛋白酶9(MMP-9)、肌酸磷化脢-同功脢(CK-MB)和肌钙蛋白(cTnI)水平的变化。结果:治疗后,观察组的ST段回落率、TIMI血流分级(CTFC)、TIMI3级和TMP3级比例均明显高于对照组(P<0.01),血清hs-CRP、BNP及MMP-9水平、血清CK-MB和cTnI峰值及持续时间均明显低于对照组(P<0.01)。结论:PCI术前给予80mg阿托伐他汀对STEMI患者的疗效显著,可提高心肌血流灌注恢复质量,抑制炎症反应,改善心室收缩功能,且安全性高。
英文摘要:
      ABSTRACT Objective: To study the effect of preoperative loading dose atorvastatin on the Hs-CRP, BNP levels and cardiac function of patients with STEMI emergency PCI. Methods: 96 cases of patients with ST elevation myocardial infarction (STEMI) who were treated with emergency percutaneous coronary intervention (PCI) in our hospital from September 2014 to April 2016 were selected and randomly divided into the control group and the observation group with 48 cases in each group. The observation group was treated with atorvastatin 80 mg before the operation and 40mg/d after the operation, while the control group was treated with atorvastatin 40mg/d after the operation. Then the postoperative perfusion situation, serum high-sensitivity C reactive protein (hs-CRP), B type natriuretic peptide (BNP) and matrix metalloproteinase 9 (MMP-9) levels in the two groups before and after the treatment were observed and compared. Results: The ST segment drop rate, TIMI3 and TMP3 ratio in the observation group were significantly higher than those of the control group (P<0.01); CTFC was significantly higher than that of the control group (t=4.43, P=0.00). The serum levels of hs-CRP, BNP and MMP-9 in the observation group were significantly lower than those of the control group (P<0.01). The serum levels of CK-MB and cTnI in the observation group were significantly lower than those of the control group (P<0.01). Conclusion: Administration of 80 mg atorvastatin was effective for the STEMI patients after PCI, which could promote the recovery of myocardial perfusion, inhibit the inflammation and improve the ventricular systolic function.
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