超短期辛伐他汀强化治疗对非ST段抬高型急性冠状动脉综合征患者冠状动脉介入治疗术后的影响

The Effects of Short-Term Treatment with Simvastatin in Patients with non ST-Segment Elevation Acute Coronary Syndrome after Percutanous Coronary Intervention

目的探讨经皮冠状动脉介入治疗(percutanous coronary intervention,PCI)术前超短期大剂量应用辛伐他汀对非ST段抬高型急性冠状动脉综合征(non ST-segment elevation acute coronary syndrome,NSTE-ACS)患者术后无复流及短期预后的影响。方法选择我院入院72 h内接受PCI治疗的128例NSTE-ACS,随机分为标准组和强化组各64例。PCI术前服用辛伐他汀3 d,强化组80 mg/d、标准组20 mg/d。观察术后无复流及1个月内主要心脏不良事件(MACE)发生情况。结果强化组无复流发生率(3.1%)低于标准组(12.5%),两组比较差异有统计学意义(χ2=3.9,P<0.05)。术后1个月,强化组MACE发生率(1.6%)低于标准组(10.9%),两组比较差异有统计学意义(χ2=4.8,P<0.05)。结论 NSTE-ACS患者PCI术前超短期大剂量服用他汀类药物可降低术后无复流及MACE发生率,改善预后。

Objective To evaluate the effect of no-reflow and prognosis of short-term treatment with large dose of Simvastain in non ST-segment elevation acute coronary syndrome（NSTE-ACS） patients who underwent successful primary percutanous coronary intervention（PCI）.Methods128 patients with NSTE-ACS undergoing PCI during 72 h after hospitalization were selected and randomly divided into normal group and intensive group,with 64 cases in each group.Both groups received oral Simvastatin for 3 days before PCI（80 mg/d in normal group,20 mg/d in intensive group）.The status of no-reflow and MACE was observed. ResultsThe incidence of no-reflow in intensive group was significantly lower than that in normal group（3.1% vs 12.5%,χ2=3.9,P0.05）,and the incidence of MACE in intensive group was also lower than that in normal group 1 moth after treatment（1.6% vs 10.9%,χ2=4.8,P0.05）.ConclusionShort-term treatment with high-dose of Simvastatin in NSTE-ACS patients before PCI could improve myocardial blood perfusion,and reduce the incidence of no-reflow and MACE.