强化他汀对首次急性前壁心肌梗死患者直接PCI治疗后1年左心功能的影响被引量：2

The Infection of Intense Atorvastatin on Left Heart Function One Year after Acute Myocardial Infarction of the Anterior Wall and Direct PCI

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摘要目的探讨强化他汀对首次急性前壁心肌梗死患者直接冠状动脉介入术(PCI)治疗后1年左心功能的影响。方法选取2012年4月至2013年9月因首次急性前壁心肌梗死行PCI治疗的患者140例,其中同意行超声检查119例,随机分为2组:强化他汀组(A组)57例,常规他汀组(B组)62例。A组入院时给予阿托伐他汀80 mg,术后给予阿托伐他汀40 mg/d(晚间),直至术后30 d,此后20 mg/d(晚间);B组给予阿托伐他汀20 mg/d(晚间)。观察患者术后1年心脏超声结果,比较A组与B组患者左室舒张末内径(LVDD),左室射血分数(EF值)及短轴缩短率(FS值),明确强化他汀治疗对首次急性前壁心肌梗死患者直接PCI后1年左心功能的影响。结果 A组患者与B组患者入院时LVDD、EF值和FS值比较,差异无统计学意义;A组患者术后1年LVDD、EF值和FS值与入院时比较,差异有统计学意义(P<0.05);B组患者术后1年,LVDD与入院时比较,差异无统计学意义;EF值和FS值与入院时比较,差异有统计学意义(P<0.05);A组患者与B组患者术后1年LVDD、EF值和FS值相比较,差异有统计学意义(P<0.05)。结论强化他汀治疗可改善首次急性前壁心肌梗死患者直接PCI后1年左心功能。 Objective To observe the influence of intense atorvastatin on left heart function one year after acute myocardial infarction of the anterior wall performed by the first time and direct PCI. Methods We selected 119 patients who had acute myocardial infarction of the anterior wall and underwent PCI at one year from April 2012 to September 2013. Cases were divided into two groups randomly with 57 patients in the intense atorvastatin group（ Group A）,and 62 patients in the conventional group（ Group B）. On admission,80 mg atorvastatin was delivered to group A,and 40 mg atorvastatin was delivered per night postoperatively until 30 days later. Then,20 mg atorvastatin was delivered per night. Group B was delivered 20 mg atorvastatin per night. We observed the influence of intense atorvastatin on left heart function after acute myocardial infarction of the anterior wall and direct PCI by comparing the LVDD,EF and FS of the two groups. Results On admission,LVDD,EF and FS had no statistically significant difference between the two groups. One year after the operation,LVDD,EF and FS were statistically significant（ P〈0. 05） comparing with admission in Group A,while LVDD had no statistically significant difference,and EF and FS were statistically significant（ P〈0. 05） when comparing with admission in Group B. One year after the operation,LVDD,EF and FS were statistically significant（ P〈0. 05） between the two groups. Conclusion Intensive-statin therapy can improve left heart function after acute anterior myocardial and direct PCI at 1 year.

作者王丹王耿韩雅玲周薇薇马蕊

机构地区辽宁中医药大学研究生院沈阳军区总医院心血管内科沈阳军区总医院影像科

出处《创伤与急危重病医学》 2015年第3期137-140,共4页 Trauma and Critical Care Medicine

基金辽宁省科学技术计划项目(2013225089) 科技部课题(2012ZX09303016-002) 研究者发起的研究基金(WS1803207)

关键词强化他汀首次急性前壁心肌梗死直接冠状动脉介入术左心功能 intensive-statin acute anterior myocardial for the first time direct PCI left heart function

分类号 R542.22 [医药卫生—心血管疾病]

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参考文献12

1张锦,刘晓红,陆卫华,李丽琪,来春林,贺业新.急性心肌梗死患者行经皮冠状动脉介入治疗前后心脏磁共振成像左心功能评价的研究[J].中国药物与临床,2013,13(8):991-993. 被引量：4
2Fonarow GC,Wright RS,Spencer FA,et al.Effect of statin use within the first 24 hours of admission for acute myocardial infarction on early morbidity and mortality[J].Am J Cardiol,2005,96(5):611-616.
3Wright RS,Bybee KA,Miller WL,et al.Reduced risks of death and CHF are associated with Tatin therapy administered acutely within the first 24 h of AMI[J].Int J Cardiol,2006,108(3):314-319.
4Patti G,Pasceri V,Colonna G,et al.Atorvastatin pretreatment improves outcomes in patients with acute coronary syndromes undergoing early percutaneous coronary intervention:results of the ARMYDA-ACS randomized trial[J].J Am Coll Cardiol,2007,49(12):1272-1278.
5Santoro GM,Carrabba N,Migliorini A,et al.Acute heart failure in patients with acute myocardial infarction treated with primary percutaneous coronary intervention[J].Eur J Heart Fail,2008,10(8):780-785.
6Bauters C,Fertin M,Delhaye C,et al.Late recovery in left ventricular systolic function after discharge of patients with a first anterior myocardial infarction[J].Arch Cardiovasc Dis,2010,103(10):538-545.
7Ottervanger1 JP,van’t Hof AWJ,Reiffers S,et al.Long-term recovery of left ventricular function after primary angioplasty for a-cute myocardial infarction[J].European Heart Journal,2001,22(9):785-790.
8Hermann J.Peri-procedural myocardial injury 2005 Update[J].Eur Heart J,2005,26(23):2493-2519.
9曹庆博,王修卫,韩增雷,孙学玉,袁涛.急诊PCI围术期强化他汀类药物治疗对急性心肌梗死患者hs-CRP、sCD40L的影响[J].中国临床研究,2011,24(8):664-665. 被引量：7
10李俊,张静,庞广杰,周琳.经皮冠状动脉介入患者围手术期强化他汀治疗的研究进展[J].中国循证心血管医学杂志,2013,5(4):426-427. 被引量：3

二级参考文献44

1李旭平,张志辉,周胜华,刘启明,胡信群,祁述善.冠状动脉斑块形态与CD40配体及妊娠相关蛋白酶-A的关系[J].中国介入心脏病学杂志,2005,13(1):28-30. 被引量：11
2辛辉.经皮腔内冠状动脉成形术后CK-MB及TNT的变化[J].青岛大学医学院学报,2005,41(2):123-124. 被引量：4
3姜文兵,傅国胜.造影剂肾病预防的研究进展[J].临床荟萃,2006,21(12):897-900. 被引量：23
4汪斌,刘志忠,张丰富.冠状动脉介入诊治中高敏C反应蛋白与造影剂肾病的相关性分析[J].中国医药,2007,2(8):457-459. 被引量：35
5Otake H, Shite J, Shinke T, et al. Relation between plasma adiponectin, high-sensitivity C-reactive protein, and coronary plaque components in patients with acute coronary syndrome [J]. Am J Cardiol, 2008,101(1) :1 -7.
6Nallamothu BK, Bates ER. Periprocedural myocardial infarction and mortality:causality versus association[ J]. J Am Coll Cardiol,2003, 42(8) :1412 - 1414.
7loannidis JP, Karvouni E, Katritsis DG. Mortality risk conferred by small elevations of creatine kinase-MB isoenzyme after percutaneous coronary intervention [ J]. J Am Coll Cardiol, 2003,42 ( 8 ) : 1406 - 1411.
8Laufs U, Kilter H, Konkol C, et al. Impact of HMG CoA reductase inhibition on small GTPascs in the heart( J]. Cardiovasc Res,2002, 53(4) :911 -920.
9Calabrb P,Yeh ET. The pleiotropic effects of statins[ J]. Curr Opin Cardiol,2005,20 ( 6 ) : 541 - 546.
10Albert MA, Danielson E, Rifai N, et al. Effect of statin therapy on C- reactive protein levels:the pravastatin inflammation/CRP evaluation (PRINCE) :a randomized trial and cohort study[J]. JAMA,2001, 286( 1 ) :64 -70.