围术期强化他汀治疗对老年ST段抬高型心肌梗死急诊PCI术后近期预后及安全性的影响
发布时间：2019-04-27 22:22
【摘要】：目的探讨围术期他汀强化治疗对ST段抬高型心肌梗死(STEMI)老年患者经皮冠状动脉介入术(PCI)后冠状动脉血流、近期主要不良心血管事件(MACE)和安全性的影响。方法入选入院前2 w未接受他汀类药物治疗的60岁以上STEMI患者80例,随机分为强化他汀组(n=40)和对照组(n=40),强化他汀组于术前2 h内及术后1 w均给予阿托伐他汀钙40 mg/d口服,1 w后改成20 mg/d,对照组入院后每晚睡前给予阿托伐他汀钙20 mg口服,疗程均为30 d。观察两组术后即刻TIMI血流分级、ST段抬高总和回落百分比、血浆肌钙蛋白(c Tn I)、白细胞介素(IL)-10、内皮型一氧化氮合酶(e NOS)水平的变化。随访30 d MACE(心源性死亡、心力衰竭、非致死性AMI、梗死后心绞痛、靶血管重运)的发生率以及一些安全性指标(肝酶、肌酸激酶等)的变化。结果强化他汀组术后即刻TIMI3级血流比例、术后心电图ST段抬高总和回落百分比≥50%的比例明显高于对照组(P0.05)。与PCI前相比,术后两组c Tn I、IL-10水平明显增加(P0.01),e NOS明显降低(P0.01),但强化组CTn I升高水平较对照组低,IL-10、e NOS水平较对照组高(P0.05)。随访30 d强化组MACE发生率以及肝功、肌肉损害等不良反应发生率与对照组相比均无统计学差异(P0.05)。结论老年STEMI患者围术期强化他汀治疗可能通过抑制急诊PCI术后炎症反应减少无复流的发生,减轻心肌损伤,并改善近期预后。
[Abstract]:Objective to investigate the effect of intensive perioperative statine therapy on coronary blood flow, (MACE) and safety after percutaneous coronary intervention (PCI) in elderly patients with ST segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI). Methods 80 STEMI patients over 60 years old who were not treated with statins 2 weeks before admission were randomly divided into intensive statins group (n = 40) and control group (n = 40). The fortified statins group was treated with 40 mg/d of Atto vastatin calcium within 2 hours before operation and 1 week after operation, and the control group was treated with 20 mg of Atto vastatin calcium every night after admission. The course of treatment was 30 days for all patients in the intensive statins group, and the control group was treated with 20 mg of Atto vastatin calcium every night after being admitted to the hospital for 30 days. The blood flow grading of TIMI, the percentage of total reduction of St segment elevation, plasma troponin (c Tn I), interleukin-10 (IL)-10) and endothelial nitric oxide synthase (Enos) (e NOS) levels were observed immediately after operation in the two groups. The incidence of cardiac death, heart failure, non-fatal AMI, post-infarction angina pectoris, target vessel revascularization and some safety indexes (liver enzyme, creatine kinase, etc.) were followed up for 30 d MACE (. Results the percentage of TIMI3 grade blood flow immediately after operation and the percentage of total reduction of ST segment elevation 鈮，
本文编号：2467359
[Abstract]:Objective to investigate the effect of intensive perioperative statine therapy on coronary blood flow, (MACE) and safety after percutaneous coronary intervention (PCI) in elderly patients with ST segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI). Methods 80 STEMI patients over 60 years old who were not treated with statins 2 weeks before admission were randomly divided into intensive statins group (n = 40) and control group (n = 40). The fortified statins group was treated with 40 mg/d of Atto vastatin calcium within 2 hours before operation and 1 week after operation, and the control group was treated with 20 mg of Atto vastatin calcium every night after admission. The course of treatment was 30 days for all patients in the intensive statins group, and the control group was treated with 20 mg of Atto vastatin calcium every night after being admitted to the hospital for 30 days. The blood flow grading of TIMI, the percentage of total reduction of St segment elevation, plasma troponin (c Tn I), interleukin-10 (IL)-10) and endothelial nitric oxide synthase (Enos) (e NOS) levels were observed immediately after operation in the two groups. The incidence of cardiac death, heart failure, non-fatal AMI, post-infarction angina pectoris, target vessel revascularization and some safety indexes (liver enzyme, creatine kinase, etc.) were followed up for 30 d MACE (. Results the percentage of TIMI3 grade blood flow immediately after operation and the percentage of total reduction of ST segment elevation 鈮，
本文编号：2467359
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