首剂阿托伐他汀强化负荷对正常低密度脂蛋白心梗患者急诊PCI中无复流的作用

The effects of first intensive dose atorvastatin on no-reflow in acute myocardial infarction patients of normal LDL-C treated with percutaneous coronary intervention

目的:观察术前负荷阿托伐他汀80mg的强化他汀治疗对于低密度脂蛋白(LDL-C)正常的急性ST段抬高心肌梗塞(STEAMI)患者行急诊经皮冠状动脉介入治疗(PCI)术中出现无复流风险的影响。方法:因STEAMI行急诊PCI治疗患者80例,入选患者的血脂LDL-C均正常;随机分为强化他汀组(强化组,n=40)及常规他汀组(常规组,n=40),强化组于手术当日术前给予阿托伐他汀首次剂量80mg预处理,1d后每日40mg,服2周,以后每日20mg长期服用;常规组手术当日于术前给予阿托伐他汀40mg,术后每日40mg,服2周,以后每日20mg长期服用;观察术中无复流的发生率。结果:两组均未出现明显不良反应。强化他汀组STEAMI患者行急诊PCI术中无复流的发生率为10%,常规他汀组无复流的发生率为22.5%,差异有统计学意义(P<0.05)。结论:急诊PCI术前首次给予80mg负荷剂量的阿托伐他汀能够降低LDL-C正常的急诊STEMI患者术中无复流的发生。

Objective：To observe the the effects of first dose 80 mg atorvastatin on no-reflow in ST-seg-ment elevation acute myocardial infarction patients of normal LDL-C treated with percutaneous coronary interven-tion .Methods：80 patients of normal LDL-C with STEAMI successfully treated with PCI were divided into the treat-ment group（40 patients ）and the control group （40 patients ） .The treatment patients were given preoperative dose of atorvastatin 80 mg before the PCI ,40 mg daily after one day for 2 weeks ,20mg daily for long-term .The control pa-tients were given atorvastatin 40 mg before the PCI ,40 mg daily for 2 weeks ,20 mg daily for long-term .The inci-dence of no-reflow was observed .Results ：There were no significant adverse reactions in the two groups .The treat-ment group of no-reflow incidence was 10% ,the control group of no-reflow was 22 .5% .The difference was statisti-cally significant （P〈0 .05） .Conclusion ：First given 80 mg atorvastatin before PCI can reduce the incidence of no-re-flow with acute STEMI of normal LDL-C .