摘要
目的观察急性心肌梗死PCI术前服用不同剂量阿托伐他汀对血浆脑钠肽以及左心室重构的影响。方法回顾性分析2018年11月-2019年10月淮安市淮安医院心内科收治的急性心肌梗死PCI患者144例,按照阿托伐他汀用药剂量差异分为A、B、C组,每组48例。A组阿托伐他汀剂量20 mg/d,B组阿托伐他汀剂量40 mg/d,C组阿托伐汀剂量80 mg/d。比较3组不同时间点血浆脑钠肽水平,左室收缩末期容积(LVESV)、左室舒张末期容积(LVEDV)与左心室射血分数(LVEF),随访8个月比较各组心血管事件发生情况。结果入院时3组患者血浆脑钠肽水平比较差异无统计学意义(P>0.05),治疗48 h、7 d、30 d时B组血浆脑钠肽水平均低于A组,C组水平低于A、B组(P均<0.01)。超声心动图检查发现,B组治疗30 d后LVESV、LVEDV小于A组,LVEF高于A组(P<0.05或P<0.01);C组治疗30 d后LVESV、LVEDV小于A、B组,LVEF高于A、B组(P均<0.01)。随访8个月,A组心血管事件总发生率为20.83%、B组为12.50%、C组为4.16%,C组总发生率低于A组(χ^(2)=6.095,P=0.014),B组与C组、A组与B组组间比较差异均无统计学意义(χ^(2)=2.182,P=0.268;χ^(2)=1.200,P=0.273)。结论急性心肌梗死PCI术前服用大剂量阿托伐他汀可改善患者血浆脑钠肽水平,缩小LVESV、LVEDV和增加LVEF,对左心室重构具有重要意义,且可有效减少心血管事件发生,预后良好。
Objective To observe the effects of different doses of atorvastatin before PCI on plasma brain natriuretic peptide and left ventricular remodeling after acute myocardial infarction. Methods 144 patients with acute myocardial infarction treated in the department of cardiology of Huai’ an Hospital of Huai’ an City from November 2018 to October 2019 were retrospectively analyzed. They were divided into groups A,B and C according to the dose difference of atorvastatin,with48 cases in each group. Group A atorvastatin dose 20 mg/d,group B atorvastatin dose 40 mg/d,group C atorvastatin dose80 mg/d. The levels of plasma brain natriuretic peptide,left ventricular end systolic volume( LVESV),left ventricular end diastolic volume( LVEDV) and left ventricular ejection fraction( LVEF) were compared in different time points in the three groups. After 8 months of follow-up,the incidence of cardiovascular events in each group was compared. Results There was no significant difference in plasma brain natriuretic peptide levels between the three groups at admission( P > 0. 05). The plasma brain natriuretic peptide levels in group B were lower than those in group A at 48 h,7 d,and 30 d,and the level in group C was lower groups A and B( both P < 0. 01). After 30 days of treatment,echocardiographic examination revealed that LVESV and LVEDV in group B were lower than those in group A,and LVEF was higher than that in group A( P < 0. 05 or P <0. 01);After 30 days of treatment in group C,LVESV and LVEDV were lower than those in groups A and B,LVEF higher than groups A and B( both P < 0. 01). Follow-up for 8 months,the total incidence of cardiovascular events in group A was 20. 83%,group B was 12. 50%,group C was 4. 16%,the total incidence of group C was lower than that of group A( χ^(2)= 6. 095,P =0. 014),group B There was no significant difference between group B and group C,group A and group B( χ^(2)= 2. 182,P =0. 268;χ^(2)= 1. 200,P = 0. 273). Conclusion Taking high-dose atorvastatin before PCI for acute myocardial infarction can improve plasma brain natriuretic peptide levels,reduce LVESV,LVEDV and increase LVEF,which is of great significance to left ventricular remodeling,it can effectively reduce the occurrence of cardiovascular events and has a good prognosis.
作者
李克刚
祁正军
LI Kegang;QI Zhengjun(Huai'an Hospital of Huai'an City,Jiangsu Province,Huai'an 223200,China)
出处
《临床合理用药杂志》
2021年第29期4-6,共3页
Chinese Journal of Clinical Rational Drug Use
关键词
急性心肌梗死
经皮冠状动脉介入手术
阿托伐他汀
血浆脑钠肽
左心室重构
Acute myocardial infarction
Percutaneous coronary intervention
Atorvastatin
Plasma brain natriuretic peptide
Left ventricular remodeling
