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[目的]探讨大剂量阿托伐他汀对急性心肌梗死(AMI)行急诊PCI的患者心肌再灌注损伤的影响。[方法]选取急性AMI患者126例,随机分为大剂量组66例及一般剂量60例,分别口服阿托伐他汀80、10mg/d,在PCI前(0h)、术后12h、24h、72h及4周时检测血清高敏C反应蛋白(hs-CRP)及术后30min及24h记录心电图,观察ST段抬高最显著导联ST段回落的情况,同时比较术后1周、2周及4周后的白细胞介素(IL-6)及肿瘤坏死因子(TNF-α)水平。[结果]大剂量阿托伐汀组与常规剂量阿托伐汀组相比较hs-CRP水平术后72h相比差异有统计学意义(P﹤0.05)。在术后4周时两组hs-CRP水平较降低,两组比较P﹤0.05。术后30min及24hST段降落≥50%者,两组比较P﹤0.05。IL-6及TNF-α水平治疗1周及2周后,两组水平比较P﹤0.01,在4周后两组水平比较P﹤0.05。[结论]阿托伐他汀在急性心梗PCI术后患者C-反应蛋白、血细胞介素-6及肿瘤坏死因子-α水平均有显著影响,高剂量组显著高于常规剂量组,在ST段水平,在术后30min及24h大剂量阿托伐他汀组均好于常规剂量组。
[Objective] To investigate the effect of high-dose atorvastatin on myocardial reperfusion injury in patients undergoing emergency PCI with acute myocardial infarction (AMI). [Methods] A total of 126 acute AMI patients were randomly divided into high dose group (n = 66) and general dose (n = 60). Atorvastatin 80 and 10 mg / d were orally administered before PCI (0h), 12h, 24h, And serum hs-CRP was detected at 4 weeks and electrocardiogram was recorded at 30 min and 24 h after operation. The ST-segment elevation was observed in the most significant lead of ST segment elevation. At the same time, 1 h, 2 wk and 4 w Week after the level of interleukin (IL-6) and tumor necrosis factor (TNF-α). [Result] The difference of hs-CRP level between high-dose atorvastatin group and conventional dose of atorvastatin group at 72h after operation was statistically significant (P <0.05). The levels of hs-CRP in both groups decreased at 4 weeks after operation, P <0.05 in both groups. After 30min and 24hST stage of the decline of ≥ 50%, the two groups were P <0.05. The levels of IL-6 and TNF-α in the two groups after one and two weeks of treatment were P <0.01, P <0.05 after 4 weeks. [Conclusion] Atorvastatin has a significant effect on the levels of C-reactive protein, interleukin-6 and tumor necrosis factor-α in patients with acute myocardial infarction. The high-dose group is significantly higher than the conventional dose group, Level, 30min and 24h after high-dose atorvastatin group were better than the conventional dose group.