普拉固早期强化治疗对急性心肌梗死患者压力和化学反射敏感性的影响

The Effect of Early Intensive Pravastatin Theapy on Baroreflex and Chemoreflex Sensitivity After Acute Myocardial Infarction.

研究在急性心肌梗死(AMI)发作的早期,普拉固强化治疗对患者压力反射敏感性(BRS)和化学反射敏感性(ChRS)的影响。采用随机、单盲、空白对照方法,共入选84例AMI患者,均在入院后24h内随机分配至对照组(n=28),传统治疗组(普拉固组20mg/d,n=28),强化治疗组(普拉固组40mg/d,n=28)。3组主要基本资料具有可比性。分别在入院时、用药后4周检测血脂水平、BRS值、ChRS值及所有不良反应。结果:普拉固组20mg/d和40mg/d治疗4周后的患者较治疗前血脂指标均有明显改善;与对照组相比,2治疗组治疗后的血脂水平有显著改善(P<0.05);2治疗组间差异无显著性。4周后3组BRS值、ChRS值较入院时均有明显改善;与对照组相比,2治疗组治疗后的BRS值、ChRS值均有显著改善(7.34±2.26,6.87±0.53vs5.66±1.34;7.83±3.36,6.38±1.25vs5.28±1.12;P均<0.01);与传统治疗组相比,强化治疗组治疗后BRS值、ChRS值的差异亦有显著性。结论:普拉固早期强化干预能改善AMI的BRS、ChRS值,且具有剂量依赖性。

To study the effect of the beneficial influence of early Pravastatin therapy with large dose on baroreflex sensitivity（BRS） and chemoreflex sensitivity（ChRS） after acute myocardial infarction（AMI） , 84 patients were divided randomly into control,pravastatin 20mg/d and Pravastatin 40mg/d groups. Blood lipid were measured on the first day and after 4 weeks, BRS, ChRS were measured on the fifth day and after 4 weeks. Total harmful responses were followed by for three weeks. Results ： After 4 weeks the levels of cholesterol, HDL-c , LDL-c, triglyceride in Pravastatin 20mg/d and 40mg/d group had significant difference compared to those before therapy;the differencebetween control and treatment group was significant（ P 〈 0.05 ） , but between two treatment groups was not significant（ P 〈0.05 ）. After 4 weeks the levels of BRS and ChRS in three groups were significantly better than those on the fifth day,but between control and treatment group was significant （ 7.34 ± 2.26,6.87 ± 0.53 vs 5.66 ± 1.34 ; 7.83 ± 3.36,6.38 ± 1.25vs 5.28 ± 1.12;all P 〈 0.05）. After 4 weeks the levels of BRS and ChRS in Pravastatin 40mg/d group were significantly better than those in Pravastatin 20mg/d group （ P 〈 0.05 ）. Conclusion ： The early intensive pravastatin therapy is effective and safe,it can improve the levels of BRS and ChRS after AMI.