高剂量阿托伐他汀钙在接受PCI术治疗的急性ST段抬高型心肌梗死患者中的应用效果

Effect of High-Dose Atorvastatin Calcium in Patients with Acute ST-Segment Elevation Myocardial Infarction Undergoing PCI

目的探讨高剂量阿托伐他汀钙在治疗接受经皮冠脉介入(PCI)术急性ST段抬高型心肌梗死(STEMI)患者中的临床价值。方法选取108例伊川县人民医院2020年6月至2022年2月收治的STEMI患者,均行PCI术治疗,采用随机双盲法将患者分为两组(参照组54例、研究组54例),术后均接受常规药物治疗,参照组接受常规剂量(20 mg)阿托伐他汀钙治疗,研究组接受高剂量(40 mg)阿托伐他汀钙治疗,比较两组治疗总有效率、治疗前、治疗4周后心功能[左心室舒张末径(LVEDD)、左心室收缩末内径(LVESD)、左心室射血分数(LVEF)]、血脂[低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、三酰甘油(TG)]水平、血清炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、超敏C反应蛋白(hs-CRP)、白细胞介素-8(IL-8)]水平及不良事件发生率。结果参照组治疗总有效率高于研究组(P<0.05);与参照组比较,治疗4周后研究组LVEDD、LVESD较低,LVEF较高(P<0.05);与参照组比较,治疗4周后研究组血清IL-1β、TNF-α、IL-8、hs-CRP、TC、TG、LDL-C水平较低,HDL-C水平较高(P<0.05);两组不良事件总发生率比较,差异无统计学意义(P>0.05)。结论高剂量阿托伐他汀钙治疗接受PCI术STEMI患者效果显著,可有效促进心功能、血脂水平改善,抑制机体炎症状态,具有良好安全性。

Objective To investigate the clinical value of high-dose atorvastatin calcium in the treatment of patients with acute ST segment elevation myocardial infarction(STEMI)undergoing percutaneous coronary intervention(PCI).Methods A total of 108 patients with acute ST-segment elevation myocardial infarction admitted to Yichuan County People’s Hospital from June 2020 to February 2022 were prospectively studied,and they all were treated with PCI.The patients were randomly divided into two groups(54 cases in the reference group and 54 cases in the study group).All patients received conventional drug treatment after operation.The reference group received conventional dose of atorvastatin calcium(20 mg),and the study group received high dose of atorvastatin calcium(40 mg).The total efficiency,cardiac function[left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)],lipids[low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),high-density lipoprotein cholesterol(HDL C),triacylglycerol(TG)]levels,serum inflammatory factors[interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),interleukin-8(IL-8),supersensitive C-reactive protein(hs-CRP)]levels,and the incidence of adverse events before and after 4 weeks of treatment were compared between the two groups.Results The total effective rate of treatment in the study group was higher than that in the reference group(P<0.05).Compared with the reference group,LVEDD and LVESD were lower and LVEF was higher in the study group after four weeks of treatment(P<0.05).Compared with the reference group,serum IL-1β,TNF-α,IL-8,hs-CRP,TC,TG,LDL-C levels were lower and HDL-C levels were higher in the study group after four weeks of treatment(P<0.05).There was no difference in the overall incidence of adverse events between the two groups(P>0.05).Conclusion High-dose atorvastatin calcium is effective in treating patients with STEMI undergoing PCI,and can effectively promote the improvement of cardiac function and lipid levels and suppress the inflammatory state of the organism,with a good safety profile.