摘要
目的 探讨不同剂量阿托伐他汀、瑞舒伐他汀、辛伐他汀对接受经皮冠状动脉介入治疗(PCI)的老年ST段抬高型急性心肌梗死(STEMI)患者的影响。方法 前瞻性选取接受PCI的180例STEMI患者作为研究对象,采用随机数字表法分为A组、B组、C组、D组、E组、F组,每组30例。A组口服低剂量辛伐他汀,B组口服高剂量辛伐他汀,C组口服低剂量阿托伐他汀,D组口服高剂量阿托伐他汀,E组口服低剂量瑞舒伐他汀,F组口服高剂量瑞舒伐他汀。比较各组患者血清炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)]、心肌损伤标志物[肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白T(cTnT)、N末端脑钠肽前体(NT-proBNP)]、心功能指标[左心室射血分数(LVEF)、心脏指数(CI)、心排血量(CO)]水平、ST段回落情况及不良心血管事件、不良反应发生情况。结果 术后1 d、术后1个月时,A组、B组、C组、D组、E组、F组的IL-6、hs-CRP、TNF-α水平均依次降低,差异有统计学意义(P<0.05);术后1 d、术后1个月时,A组、B组、C组、D组、E组、F组的cTnT、CK-MB、NT-proBNP水平均依次降低,差异有统计学意义(P<0.05);术后1个月时,A组、B组、C组、D组、E组、F组的LVEF、CO、CI均依次升高,差异有统计学意义(P<0.05);A组、B组、C组、D组、E组、F组的ST段回落者占比依次升高,差异有统计学意义(P<0.05);各组患者不良心血管事件总发生率、不良反应总发生率比较,差异均无统计学意义(P>0.05)。结论 低剂量、高剂量的阿托伐他汀、瑞舒伐他汀、辛伐他汀应用于PCI术后STEMI患者,均可有效减轻炎症反应,改善心肌功能,促进ST段回落,其中高剂量瑞舒伐他汀效果最佳。
Objective To investigate the effects of different dosages of atorvastatin,rosuvastatin,and simvastatin in elderly patients with ST-segment elevation acute myocardial infarction(STEMI)undergoing percutaneous coronary intervention(PCI).Methods A total of 180 patients with STEMI undergoing PCI were prospectively selected as study subjects and divided into group A,group B,group C,group D,group E,and group F using a random number table method,with 30 patients in each group.The group A received low-dose simvastatin orally,the group B received high-dose simvastatin orally,the group C received low-dose atorvastatin orally,the group D received high-dose atorvastatin orally,the group E received low-dose rosuvastatin orally,and the group F received high-dose rosuvastatin orally.The levels of serum inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP)],myocardial injury markers[creatine kinase isoenzyme(CK-MB),cardiac troponin T(cTnT),N-terminal pro-brain natriuretic peptide(NT-proBNP)],cardiac function indicators[left ventricular ejection fraction(LVEF),cardiac index(CI),cardiac output(CO)],as well as the ST-segment resolution,occurrence of adverse cardiovascular events,and adverse reactions were compared among the groups.Results At 1 day and 1 month postoperatively,the levels of IL-6,hs-CRP,and TNF-αdecreased successively in groups A,B,C,D,E,and F(P<0.05).At 1 day and 1 month postoperatively,the levels of cTnT,CK-MB,and NT-proBNP also decreased successively in the groups A,B,C,D,E,and F(P<0.05).At 1 month postoperatively,the LVEF,CO,and CI increased successively in the groups A,B,C,D,E,and F(P<0.05).The proportions of patients with ST-segment resolution successively increased in the groups A,B,C,D,E,and F(P<0.05).There were no statistically significant differences in the total incidence of adverse cardiovascular events and adverse reactions among the groups(P>0.05).Conclusion Both low-dose and high-dose atorvastatin,rosuvastatin,and simvastatin can effectively relieve inflammation reactions,improve myocardial function,and promote ST-segment resolution in elderly patients with STEMI undergoing PCI,with high-dose rosuvastatin showing the best effect.
作者
刘华
张建刚
李冰
王德广
马增才
徐泽升
LIU Hua;ZHANG Jiangang;LI Bing;WANG Deguang;MA Zengcai;XU Zesheng(Department of Cardiology,Cangzhou Central Hospital of Hebei Province,Cangzhou,Hebei,061000)
出处
《实用临床医药杂志》
CAS
2024年第9期62-66,72,共6页
Journal of Clinical Medicine in Practice
基金
河北省卫生健康委科研基金项目-青年科技课题(20220380)。
