瑞舒伐他汀对急性ST段抬高型心肌梗死择期PCI术患者心功能的影响

Effect of rosuvastatin on cardiac function in patients with acute ST segment elevation myocardial infarction undergoing elective

目的探讨瑞舒伐他汀对急性sT段抬高型心肌梗死（segmentelevation myocar dialinfarction，STEMI）择期行经皮冠状动脉介入术（PCI）患者心功能的影响。方法选择重庆三峡中心医院就诊的STEMI择期行PCI术患者150例为研究对象，随机分为观察组与对照组各75例。两组术前均给予抗凝、抑制心室重构及抗心肌缺血等常规治疗，观察组在常规治疗基础上于PCI术前7天口服瑞舒伐他汀10mg／d。比较PCI术前及术后12周时两组氨基酸N端脑钠肽（NT—proBNP）及超敏C-反应蛋白（hs—CRP）水平、6min步行距离（6MWT）、超声心动图数据及主要心血管不良事件的发生率（MACE）。结果术后12周时两组的6MWT及正常心脏舒张功能的比例较手术前明显增加，观察组的6MWT、正常舒张功能的比例、左室射血分数明显高于对照组，观察组的NT—proBNP、hs—CRP及MACE的发生率明显低于对照组，差异均有统计学意义（P〈0．05）。结论STEMI行择期PCI术患者术前7d口服瑞舒伐他汀可明显降低其炎性指标，明显改善心脏收缩及舒张功能且不增加主要心血管事件（MACE）的发生率。

Objective To investigate the effect rosuvastatin on cardiac function in patients with acute ST segment elevation myocardial infarction undergoing elective percutaneous coronary intervention （PCI）. Methods 150 patients with acute STEMI treated in our hospital were divided into observation group and control group, and 75 cases in each group. The two groups were given antieoagulation, inhibition of ventricular remodeling and anti - myocardial ischemia and other conventional treatment. The patients in observation group were orally administrated with rosuvastatin 10 mg/d based on the conventional treatment 7 days before PCI. Amino acid N -terminal brain natriuretie peptide （NT - proBNP）, high sensitive C reactive protein （hs -CRP） levels, 6 minutes walk distance （6MWT）, ultrasound heartbeat graph data and major adverse cardiovascular events （MACE） incidence of two groups were compared at preoperative and postoperative 12 weeks. Results At 12 weeks of post - operation, 6MWT and normal cardiac diastolic function proportion compared to pre - operation significant increase; 6MWT, normal diastolic function ratio, left ventrieular ejection fraction of observation group was significantly higher than that of the control group ; the NT - ProBNP, hs - CRP and MACE incidence of the observation group was significantly lower than that of the control group. The difference was statistically significant （ P 〈 0. 05 ）. Conclusion Patients with acute STEMI undergoing PCI oral rosuvastatin at 7 days of pre - operation can significantly reduce the inflammatory markers, significantly improve cardiac systolic and diastolic function and does not increase the incidence of major cardiovascular events, worthy of clinical reference.