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目的研究经皮冠状动脉介入治疗(PCI)术前应用强化阿托伐他汀疗法对首次急性前壁心肌梗死患者的疗效及术后不良心血管事件(MACE)发生率的影响。方法选择2011年3月至2015年3月我院急诊拟行PCI治疗的首次急性前壁心肌梗死发病患者180例,采用随机数字表法将其分为大剂量组、小剂量组、对照组,对其进行不同剂量阿托伐他汀术前、术后处理。对3组患者术后1周、3个月、6个月的hs-CRP、基质金属蛋白酶-9(MMP-9)、脑钠肽(BNP)水平进行检测,超声检测左室舒张末期容积(LVEDV)、左室舒张末期内径(LEVDD)、左室收缩末期内径(LVESD)、左室收缩末期容积(LVESV)、左室射血分数(LVEF)等指标,对比各组间差异。记录1年后MACE发生率。结果 3组患者基线资料及入院时基本指标情况差异均无统计学意义。术后1周hs-CRP、MMP-9、BNP水平,大剂量组明显低于小剂量组、对照组(P<0.05),小剂量组与对照组比较差异无统计学意义(P>0.05);术后3、6个月其水平为,大剂量组<小剂量组<对照组。术后超声结果显示,对照组术后1周与治疗第3个月后LEVDD、LVESD、LVEDV、LVESV、LVEF均无改善(P>0.05);大剂量组、小剂量组术后1周无改善,治疗3个月与6个月后其结果均有明显好转(P<0.05);治疗3个月后,小剂量组明显优于对照组,大剂量组明显优于小剂量组和对照组(P<0.05)。1年后MACE发生率大剂量组、小剂量组、对照组分别为13.3%、20.0%、21.7%,但差异无统计学意义(P>0.05)。结论 PCI术前对急性前壁心肌梗死首发患者应用强化阿托伐他汀疗法可有效抑制炎症,改善心功能,促进预后,降低MACE发生率。
Objective To investigate the effect of percutaneous coronary intervention (PCI) on atorvastatin in patients with acute anterior myocardial infarction (AMI) and the incidence of postoperative adverse cardiovascular events (MACE). Methods From March 2011 to March 2015,180 cases of acute first anterior myocardial infarction in our hospital were enrolled in this study. They were divided into high dose group, low dose group, control group, Atorvastatin with different doses of preoperative and postoperative treatment. The levels of hs-CRP, MMP-9 and BNP were measured at 1 week, 3 months and 6 months after operation in all three groups. The left ventricular end-diastolic volume (LVEDV), left ventricular end diastolic diameter (LEVDD), left ventricular end-systolic diameter (LVESD), left ventricular end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF) Record the incidence of MACE after 1 year. Results There was no significant difference in the baseline data of the three groups and the basic indexes at admission. The levels of hs-CRP, MMP-9 and BNP in the first week after operation were significantly lower than those in the low-dose group and the control group (P <0.05), but there was no significant difference between the low-dose group and the control group ; 3,6 months after the level of its high-dose group 0.05). There was no improvement at 1 week in the high-dose group and the low-dose group (P <0.05). After three months of treatment, the low-dose group was significantly better than the control group, the high-dose group was significantly better than the low-dose group and the control group P <0.05). The incidence of MACE after 1 year was 13.3%, 20.0% and 21.7% in the high-dose group, the low-dose group and the control group respectively, but the difference was not statistically significant (P> 0.05). Conclusions Pretreatment of atorvastatin with atorvastatin can effectively suppress inflammation, improve cardiac function, promote prognosis and reduce the incidence of MACE in patients with acute anterior myocardial infarction.