任美欣,严松彪,陈晖

• 1:首都医科大学附属北京友谊医院心内科
• 2:首都医科大学附属北京佑安医院

摘要(Abstract)：

目的探讨直接经皮冠状动脉介入治疗(PPCI)前超短期(1～2h)应用大剂量阿托伐他汀(80mg)对急性ST段抬高心肌梗死(STEMI)患者心肌缺血/再灌注损伤(I/R)的作用及短期预后的影响。方法入选85例行PPCI的STEMI患者,按照随机数字表法分为两组,他汀组(再灌注前1～2h给予阿托伐他汀80mg)36例和对照组49例。测定发病后CK-MB、cTnT峰值和达峰时间。于血管再通后测定TIMI血流分级(TFG)、TIMI血流帧数计数(TFC)和校正的TFC(CTFC)以及心肌呈色分级(MBG)。分别于入心内科重症监护病房(CCU)后第1天及发病后1个月行超声心动图检查(UCG),应用Simpson's法测定左心室射血分数(LVEF)。试验主要终点为30天主要不良心血管事件的发生。结果两组患者基础资料差异无统计学意义。与对照组相比,他汀组的CK-MB峰值降低,差异具有统计学意义[(252.11±206.13)U/L比(345.88±242.51)U/L,t=1.922,P=0.047]。两组患者入院UCG检查各项指标差异均无统计学意义,他汀组与对照组相比1个月时LVEF升高,但差异无统计学意义(0.62比0.58,t=-1.907,P=0.050)。结论 PPCI前超短期应用大剂量阿托伐他汀可以减轻心肌缺血再灌注损伤。阿托伐他汀预处理有可能改善急性心肌梗死(AMI)患者心功能。

关键词(KeyWords)： 血管成形术,经腔,经皮冠状动脉;阿托伐他汀;心肌再灌注损伤;心室功能

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 任美欣,严松彪,陈晖

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