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目的:探讨阿托伐他汀强化治疗对急性ST段抬高型心肌梗死患者经皮冠状动脉介入治疗术后脂蛋白相关磷脂酶A2及炎症因子的影响。方法:选取98例行急诊经皮冠状动脉介入治疗术的急性ST段抬高型心肌梗死患者作为研究对象,随机分为A组和B组,各49例。A组患者术前顿服阿托伐他汀40 mg,术后继续口服阿托伐他汀40 mg/24 h;B组患者术前顿服阿托伐他汀20mg,术后继续口服阿托伐他汀20 mg/24 h。比较两组患者在治疗前后的脂蛋白相关磷脂酶A2(Lp-PLA2)、白细胞介素(IL)-6/肿瘤坏死因子(TNF)-α、丙氨酸转氨酶(ALT)及天冬氨酸转氨酶(AST)等炎症因子的水平。结果:治疗前两组患者的Lp-PLA2、IL-6、TNF-α、ALT及AST等因子水平的差异均无统计学意义(P>0.05);治疗后,两组患者的Lp-PLA2、IL-6、TNF-α、ALT及AST等因子水平均高于治疗前(P<0.05),且A组患者的Lp-PLA2、IL-6及TNF-α因子水平明显低于B组(P<0.05),两组患者ALT、AST的水平无统计学差异(P>0.05)。结论:围术期阿托伐他汀强化治疗能显著降低急性ST段抬高型心肌梗死患者的炎症因子水平与稳定斑块,疗效显著。
Objective: To investigate the effect of atorvastatin on lipoprotein-associated phospholipase A2 and inflammatory factors after percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction. Methods: A total of 98 patients with acute ST-segment elevation myocardial infarction who underwent emergency percutaneous coronary intervention were randomly divided into group A and group B, with 49 cases in each. Patients in group A were treated with atorvastatin 40 mg preoperatively, and atorvastatin 40 mg / 24 h after operation. Patients in group B received atorvastatin 20 mg preoperatively, and atorvastatin 20 mg / 24 h. The levels of Lp-PLA2, IL-6 / TNF-α, ALT and aspartate Aminotransferase (AST) and other inflammatory cytokines. Results: There was no significant difference in the levels of Lp-PLA2, IL-6, TNF-α, ALT and AST between the two groups before treatment (P> 0.05) The levels of IL-6, TNF-α, ALT and AST were significantly higher than those before treatment (P <0.05), and the levels of Lp-PLA2, IL-6 and TNF-α in group A were significantly lower than those in group B <0.05). There was no significant difference in the levels of ALT and AST between the two groups (P> 0.05). Conclusion: Perioperative atorvastatin treatment can significantly reduce the levels of inflammatory cytokines and stable plaques in patients with acute ST-segment elevation myocardial infarction. The curative effect is significant.