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目的观察强化阿托伐他汀治疗对行急诊冠状动脉介入治疗(PCI)的急性ST段抬高型心肌梗死患者冠状动脉无复流和心功能的影响。方法将108例24h内行急诊冠状动脉介入治疗的急性ST段抬高型心肌梗死患者随机分为观察组38例及对照组70例,强化阿托伐他汀治疗者(首剂负荷量80mg,后40mg/d,口服6个月,继之20mg/d口服)为观察组,常规治疗者(首剂负荷量40mg,后20mg/d口服)为对照组,比较两组患者梗死相关动脉术后心肌梗死溶栓实验血流分级,观察两组入院时、术后第1个月及第7个月时的左室射血分数、左室收缩末期容积、左室舒张末期容积、血浆N-端脑钠肽前体水平,并观察术后7个月内两组患者主要不良心血管事件发生率。结果 1观察组与对照组比较,术后梗死相关动脉心肌梗死溶栓试验血流分级提高(P<0.05);2术后l月及7个月,观察组血浆N-端脑钠肽前体水平下降(P<0.01),左室射血分数升高(P<0.05),左室舒张末期容积及左室收缩末期容积均减少(P<0.05);与对照组比较差异均有统计学意义;3术后7个月内观察组主要不良心血管事件发生率降低(P<0.05)。结论在行急诊PCI的急性心肌梗死患者中,强化阿托伐他汀治疗策略对于改善术后冠状动脉无复流及心功能优于常规治疗方法。
Objective To observe the effects of atorvastatin on coronary artery no-refraction and cardiac function in patients with acute ST-segment elevation myocardial infarction undergoing emergency coronary intervention (PCI). Methods A total of 108 patients with acute ST-segment elevation myocardial infarction treated by emergency PCI during the last 24 hours were randomly divided into observation group (38 cases) and control group (70 cases). Atorvastatin treatment group (first dose of 80mg, / d, oral for 6 months, followed by oral 20mg / d) for the observation group, conventional treatment (the first dose of 40mg, after 20mg / d orally) as the control group, compared two groups of patients after infarction related artery myocardial infarction Thrombolysis blood flow was graded to observe left ventricular ejection fraction, left ventricular end-systolic volume, left ventricular end-diastolic volume, plasma N-terminal natriuretic peptide at the first month and the seventh month after operation Peptide precursors, and observed the incidence of major adverse cardiovascular events in both groups within 7 months after operation. Results 1 Compared with the control group, the blood flow grade of myocardial infarction-related myocardial infarction thrombolysis increased (P <0.05) in the observation group and the control group. 2 After 1 month and 7 months, the plasma N-terminal pro-brain natriuretic peptide (P <0.01), left ventricular ejection fraction increased (P <0.05), left ventricular end-diastolic volume and left ventricular end-systolic volume decreased (P <0.05), compared with the control group, the differences were statistically significant ; 3 The incidence of major adverse cardiovascular events in the observation group decreased within 7 months after operation (P <0.05). Conclusions In patients with acute myocardial infarction who underwent emergency PCI, the strategy of enhancing atorvastatin is superior to conventional treatment in improving postoperative coronary artery no-reflow and cardiac function.