摘要
目的评价早期大剂量应用阿托伐他汀对改善急性心肌梗死患者冠状动脉微循环功能障碍及心室重塑的效果。方法选取我院164例就诊的急性心肌梗死患者,依据给药方案不同分为:试验组82例,经皮冠状动脉介入治疗术术前即刻口服阿托伐他汀40 mg,术后每日2次、每次20 mg口服;对照组82例,经皮冠状动脉介入治疗术术后阿托伐他汀20 mg,睡前口服。随访1年后,检测并比较两组血清一氧化氮、血管内皮生长因子及血栓素β2水平的差异;比较两组左心室射血分数(LVEF)、左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)和室壁运动积分指数(WMSI)的差异;比较两组再次接受冠状动脉造影检查患者的TIMI分级及心肌灌注心肌显色分级(MBG)差异。结果与对照组相比,试验组血清一氧化氮、血管内皮生长因子水平显著增高,而血栓素β2水平显著降低(P<0.05);试验组的LVEF水平显著增高,而LVESV、LVEDV、WMSI水平显著降低(P<0.05)。试验组患者的TIMI及MBG分级较对照组患者显著改善(P<0.05)。结论早期大剂量应用阿托伐他汀能显著改善急性心肌梗死患者的冠状动脉微循环障碍及心室重塑程度。
Aim To analyze the effect of early and large administration of atorvastatin on coronary microcirculatory disturbance and ventricular remodeling in patients with acute myocardial infarction（ AMI）. Methods The 164 patients with AMI were chosen and divided into two groups,research group（ pre-PCI administered atorvastatin 40 mg at draught and post-PCI oral intake of atorvastatin 20 mg,bid） and control group（ post-PCI oral intake of atorvastatin 20 mg, qn）,according to dosage regimen of atorvastatin. Each group had 82 cases. After one year follow-up,the levels of serum nitric oxide（ NO）,vascular endothelial growth factor（ VEGF） and thromboxane β2（ TXβ2） were detected and compared between two groups. And the levels of left ventricular ejection fraction（ LVEF）,left ventricular end-systolic volume（ LVESV）,left ventricular end-diastolic volume（ LVEDV） and wall motion score index（ WMSI） were also detected and compared between two groups. The classes of thrombolysis in myocardial infarction（ TIMI） and myocardial blush grade（ MBG） of patients which received coronary angiography were compared between two groups. Results Compared to control group,the levels of serum NO and VEGF in research group were higher,but serum TXβ2 were lower（ P〈0. 05）. And the levels of LVESV,LVEDV and WMSI in research group were lower than in control group,but the level of LVEF was higher than in control group（ P〈0. 05）. The classes of TIMI and TMPG in research group were better than in control group（ P〈0. 05）. Conclusion The early administration of atorvastatin can obviously improve the coronary microcirculatory disturbance and ventricular remodeling in patients with AMI.
出处
《中国动脉硬化杂志》
CAS
CSCD
北大核心
2014年第4期367-370,共4页
Chinese Journal of Arteriosclerosis
关键词
急性心肌梗死
阿托伐他汀
微循环
心室重塑
Acute Myocardial Infarction
Atorvastatin
Microcirculation
Ventricular Remodeling
