急性前壁心肌梗死患者直接PCI后阿托伐他汀不同用药剂量疗效比较

Efficacy of Percutaneous Coronary Intervention for Acute Anterior Myocardial Infarction Patients with Two Kinds of Dosage for Atorvastatin

为探讨直接经皮冠状动脉介入治疗(PCI)首次急性前壁心肌梗死患者,在不同剂量他汀药物治疗后住院期间疗效比较,纳入首次诊断为急性前壁心肌梗死并接受直接PCI治疗的患者140例,随机分为强化治疗组和对照组。强化治疗组入院时顿服阿托伐他汀80mg,术后40mg/晚,直至出院;对照组口服阿托伐他汀20mg/晚。术前及术后、出院前测定心肌标记物,术前及出院前测定血浆氨基末端B型利钠肽前体(NT-proBNP),采用彩色多普勒超声检测左室射血分数(LVEF)的变化,同时记录住院期间主要心脏不良事件(MACEs)的发生。结果出院时LVEF值差异无统计学意义(P=0.249),NT-proBNP出院前较术前升高,对照组升高显著(P=0.000)。组间比较NT-proBNP,对照组显著高于强化组(P=0.020)。住院期间两组患者无MACEs发生。首次急性前壁心肌梗死患者直接PCI后,强化阿托伐他汀治疗短期内可改善左心功能。

To study the efficacy of percutaneous coronary intervention for acute anterior myocardial infarction on patients with different doses statin therapy during hospitalization, a total of 140 patients with first acute anterior myocardial infarction were randomly divided into two groups. The experiment group was given 80 mg atorvastatin before PCI in combination with 40 mg atorvastatin after PCI, until discharge. The control group was given 20 mg atorvastatin each night. Before PCI, 24h after PCI and before discharge, the levels of cardiac markers were detected. NT-pro brain natriuretic peptide （NT-proBNP） and left ventricular ejection fraction （LVEF）that examined by using Doppler echocardiography were detected before the operation and discharge. The incidence of major adverse cardiovascular events was recorded during the period of hospitalization. Comparing between the two groups, the LVEF had no significant difference （P=0. 249）. During the period of hospitalization, NT-proBNP in the control group was higher than before （P= 0.00）. Compared with the study group, the level of NT-proBNP in the contrd group was significantly higher than that after the treatment （P=0.02）. There were no major adverse cardiac events （MACEs） occurring during the hospitalization. Therefore, the intensive treatment of short-term atorvastatin can reduce the value of NT-proBNP, and can improve left ventricular function for patients with the first acute anterior myocardial infarction after directly to PCI.