高强度他汀治疗对早发冠心病STEMI后直接行PCI患者预后的影响

Effect of High-intensity Statin Treatment on Prognosis of Patients with Early-onset Coronary Heart Disease who Underwent Direct PCI after STEMI

目的:分析高强度瑞舒伐他汀治疗早发冠心病急性ST段抬高型心肌梗死(STEMI)患者的临床效果。方法:选取2021年1月—2023年1月在酒钢医院心内科住院的130例早发冠心病SETMI患者作为研究对象;在直接经皮冠状动脉介入治疗(PCI)后随机分为试验组(n=63)和对照组(n=67)。两组均给予常规基础治疗,试验组予以瑞舒伐他汀钙片20 mg/d,对照组给予瑞舒伐他汀钙片10 mg/d,连续服用12个月。观察两组血脂指标、心功能指标、药物不良反应发生率、主要心血管不良事件(MACE)发生率、TIMI血流分级、冠状动脉支架内再狭窄(ISR)发生率、冠状动脉慢血流现象(CSFP)。结果:治疗后,两组总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)均低于治疗前,且试验组甘油三酯(TG)低于治疗前,高密度脂蛋白胆固醇(HDL-C)高于治疗前,差异有统计学意义(P<0.05)。两组药物不良反应总发生率比较,差异无统计学意义(P>0.05)。两组总MACE发生率比较,差异无统计学意义(P>0.05)。两组TIMI血流分级、ISR发生率比较,差异无统计学意义(P>0.05),试验组出现CSFP患者占比低于对照组,差异有统计学意义(P<0.05)。结论:高强度瑞舒伐汀治疗对早发冠心病SETMI患者的梗死相关动脉(IRA)有一定的保护作用,且药物不良反应与标准剂量相当,安全性好。

Objective:To analyze the clinical effect of high-intensity statin treatment in the treatment of early-onset coronary heart disease acute ST-segment elevation myocardial infarction(STEMI).Method:A total of 130 patients with acute SETMI with earlyonset coronary heart disease who were hospitalized in the Department of Cardiology,Jiugang Hospital from January 2021 to January 2023 were selected as the study objects.After direct percutaneous coronary intervention(PCI),they were randomly divided into experimental group(n=63)and control group(n=67).Both groups were given conventional basic treatment,the experimental group was given Rosuvastatin Calcium Tablets 20 mg/d,the control group was given Rosuvastatin Calcium Tablets 10 mg/d,continuous administration for 12 months.Blood lipid indexes,cardiac function indexes,incidence of adverse drug reactions,incidence of major adverse cardiovascular events(MACE),TIMI blood flow grade,incidence of intra-stent restenosis(ISR)of coronary artery,and coronary slow flow phenomenon(CSFP)in the two groups were observed.Result:After treatment,total cholesterol(TC)and low density lipoprotein cholesterol(LDL-C)in two groups were lower than those before treatment,triglyceride(TG)in experimental group was lower than that before treatment,and high density lipoprotein cholesterol(HDL-C)was higher than that before treatment,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse drug reactions between the two groups(P>0.05).There was no significant difference in the incidence of MACE between the two groups(P>0.05).There were no significant differences in TIMI blood flow grading and incidence of ISR between the two groups(P>0.05),and the proportion of CSFP patients in the experimental group was lower than that in the control group,the differences were statistically significant(P<0.05).Conclusion:High-intensity Rosuvastine treatment has a certain protective effect on infarct-related artery(IRA)in patients with early-onset coronary heart disease and SETMI.The adverse drug reactions were comparable to the standard dose,and the safety was good.