论文部分内容阅读
目的:探讨大剂量阿托伐他汀对老年非ST段抬高型急性冠状动脉综合征(NSTEACS)经皮冠状动脉介入治疗术(PCI)相关性心肌梗死的影响。方法:将157例老年NSTEACS患者随机分为负荷组81例和对照组76例,负荷组PCI术前12h顿服阿托伐他汀80mg,术后1周每天服用40mg,对照组常规服用阿托伐他汀20mg。两组术前、术后8、12和24h抽取肘静脉血,检测血清肌酸激酶同工酶(CK-MB)、血浆肌钙蛋白I(cTnI)等;随访30d主要不良心脏事件发生率。结果:负荷组CK-MB和cTnI升高发生率均较对照组显著降低(37.9%︰50.5%,P=0.002;5.4%︰22.6%,P=0.041);负荷组PCI相关的心肌梗死发生率较对照组显著降低(12.6%︰33.4%,P=0.035;4.3%︰11.8%,P=0.034);多元回归分析显示,负荷剂量的阿托伐他汀预处理能降低67%的PCI相关性心肌梗死的发生率;两组均未发生死亡和再血管化事件,肝功能损害等不良反应两组差异无统计学意义。结论:PCI术前应用80mg负荷剂量阿托伐他汀治疗,能减少老年NSTEACS患者PCI术相关的心肌梗死发生率,且安全有效。
Objective: To investigate the effect of high-dose atorvastatin on myocardial infarction associated with percutaneous coronary intervention (PCI) in elderly patients with non ST-segment elevation acute coronary syndrome (NSTEACS). Methods: A total of 157 elderly patients with NSTEACS were randomly divided into load group (n = 81) and control group (n = 76). Patients in the load group received atorvastatin 80 mg 12 h before PCI and 40 mg daily after 1 week. Statin 20mg. The elbow venous blood samples were collected at 8, 12 and 24 h after operation. Serum CK-MB and cTnI were measured in both groups. The incidence of major adverse cardiac events at 30 days of follow-up was observed. Results: The incidences of CK-MB and cTnI in the stress group were significantly lower than those in the control group (37.9%: 50.5%, P = 0.002; 5.4%: 22.6%, P = 0.041) Multivariate regression analysis showed that atorvastatin at a loading dose decreased 67% of PCI-related myocardium (P <0.05), compared with the control group (P = 0.035; 4.3%: 11.8%, P = The incidence of infarction was not significantly different between the two groups. No adverse events such as death and revascularization, hepatic dysfunction were found between the two groups. Conclusions: Pretreatment with 80 mg loading dose of atorvastatin can reduce the incidence of PCI-related myocardial infarction in elderly patients with NSTEACS and is safe and effective.