阿托伐他汀序贯治疗对接受急症PCI术急性心肌梗死患者缺血修饰白蛋白的影响

Effect of sequential therapy of atorvastatin on the levels of ischemia modified albumin in patients undergoing emergency percutaneous coronary intervention for acute ST-segment elevation myocardial infarction

目的探讨阿托伐他汀序贯治疗对接受急症经皮冠状动脉介入治疗(PCI)急性心肌梗死患者血清缺血修饰白蛋白(IMA)的影响。方法收集2010年9月至2014年1月收治的符合纳入标准的83例急性ST段抬高型心肌梗死(STEMI)患者,随机分为阿托伐他汀常规治疗组(n=40,对照组)和序贯治疗组(n=43),对照组阿托伐他汀20 mg/d,序贯治疗组术前80 mg/d,术后40 mg/d,3个月后20 mg/d。观察术前及术后2、4、6、8、10、12、14 h IMA,术中及术后6个月主要心血管不良事件(MACE)。结果序贯治疗组PCI术后血清IMA水平明显低于常规治疗组,差异有统计学意义(P<0.05);序贯治疗组术后6个月MACE发生率明显明显低于常规治疗组,差异有统计学意义(P<0.05)。结论阿托伐他汀序贯治疗可显著改善急症PCI患者心肌缺血,对心肌起主要保护作用,并降低术后MACE发生率,安全有效。

Objective To investigate the effect of sequential therapy of atorvastatin on the levels of ischemia modified albumin （IMA） in acute myocardial infarction （AMI） patients undergoing emergency percutaneous coronary intervention （PCI）. Methods A total of 83 patients with acute ST-segment elevation myocardial infarction, who were admitted to authors＇ hospital during the period from September 2010 to January 2014, were enrolled in this study. The patients were randomly divided into the control group （n=40, receiving conventional atorvastatin treatment） and the study group （n=43, receiving sequential therapy of atorvastatin）. The dose of atorvastatin in the control group was 20 mg/d. In the study group, the preoperative dose of atorvastatin was 80 rag/d, and after PCI the close was 40 mg/d for 3 months followed by 20 mg/d. Serum IMA levels were determined before PCI as well as at 2, 4, 6, 8, 10, 12 and 14 hours after PCI. The major adverse cardiovascular events （MACE） occurred during PCI and within 6 months after PCI were recorded. Results After PCI, the serum IMA level in the study group was obviously lower than that in the control group, the difference was statistically significant （P〈0.05）. The occurrence of MACE within 6 months after PCI in the study group was remarkably lower than that in the control group, the difference was statistically significant （P〈0.05）. Conclusion The sequential therapy of atorvastatincan significantly improve myocardial ischemia in AMI patients undergoing emergency PCI; it plays an important role in protecting myoeardium and reducing the incidence of postoperative MACE. This therapy is clinically safe and effective.