瑞舒伐他汀对急性ST段抬高型心肌梗死患者冠状动脉支架术后再狭窄的影响

Efficacy of rosuvastatin to restenosis after percutaneous coronary intervention in patients with ST- segment elevation myocardial infarction

目的探讨瑞舒伐他汀和阿托伐他汀对急性ST段抬高型心肌梗死患者冠状动脉支架术后再狭窄的影响。方法将146例进行冠状动脉支架植入的急性ST段抬高型心肌梗死患者分为试验组71例和对照组75例。对照组于术前30 min予以瑞舒伐他汀20 mg口服,术后第1天开始每晚口服瑞舒伐他汀20mg;试验组于术前30 min给予阿托伐他汀40 mg口服,术后第1天开始每晚口服阿托伐他汀40 mg,2组疗程均为6个月。术后6个月,比较2组患者再发心绞痛、支架血管再狭窄率、总胆固醇和不良反应发生率有无差异。结果术后6个月,试验组再发心绞痛1例,再狭窄1例,对照组再发心绞痛2例,再狭窄1例,差异无统计学意义(P>0.05)。术后,2组患者血清总胆固醇较术前均显著降低(P<0.05),试验组术后2个月血清总胆固醇显著低于对照组(P<0.05)。试验组死亡1例,恶心呕吐2例,对照组死亡2例,转氨酶升高1例,2组不良反应发生率比较差异无统计学意义(P>0.05)。结论瑞舒伐他汀与阿托伐他汀预防冠状动脉支架术后再狭窄的临床效果无显著差异,但瑞舒伐他汀降脂效果更为明显。

Objective To investigate the efficacy of rosuvastatin and atorvastatin to restenosis after percutaneous coronary intervention in patients with ST- segment elevation myocardial infarction（ STEMI）.Methods One hundred fourty- six patients with STEMI were divided into control and treatment group. Seventy- one cases in the treatment group were received the rosuvastatin 20 mg at 30 min before operation,and oral rosuvastatin 20 mg on the first day until 6 months. And 75 patients in the control group were received atorvastatin 40 mg at 30 min before operation, and oral atorvastatin 40 mg on the first day until 6months. After 6 months of treatment,recurrent angina,stent restenosis rate,total cholesterol and the incidence of adverse drug reactions in two groups were compared. Results After 6 months of treatment,one case of angina pectoris and one case of restenosis in the treatment group were found. There was two patients with angina pectoris and one patient of restenosis in control group. The recurred of angina pectoris or restenosis rate was not different between the two groups（ P 0. 05）. The serum level of total cholesterol significantly decreased in both two groups（ P 0. 05）. And after 2 months of treatment,the total cholesterol in treatment group was lower than that in the control group（ P 0. 05）. During the following 6 months,2 cases were death,2 cases were nausea and vomit in the treatment group,and 2 cases were death and 1 case was liver function damage in the control group. No statistical difference wwas found between the two groups. Conclusion No difference for restenosis was found between the two group,but patients received rosuvastatin had lower level of total cholesterol.