山东医药2018，Vol.58Issue(6)：19-23,5.DOI:10.3969/j.issn.1002-266X.2018.06.005
术前强化剂量阿托伐他汀口服对心肌梗死患者PCI术后无复流、心功能及预后的影响
Effects of preoperative oral administration of intensive-dose atorvastatinon on no-reflow,cardiac function, and prognosis of patients with myocardial infarction after PCI
劳翼 1张劲 1冯力 1袁勇 1张励庭 1黄炫生 1李明星1
作者信息
- 1. 中山大学附属中山医院,广东中山528400
- 折叠
摘要
Abstract
Objective To investigate the effects of preoperative oral administration of intensive-dose atorvastatin on no-reflow,cardiac function,and prognosis of patients with myocardial infarction after percutaneous coronary intervention (PCI).Methods Ninety-six patients with myocardial infarction who received PCI were randomly divided into the routinedose group and intensive-dose group with 48 cases in each group.The patients of the two groups both received the conventional treatment,and on this basis,the routine-dose group received oral administration of 20 mg atorvastatin immediately before the operation,while the intensive-dose group received 80 mg.The blood flow fractionation of thrombolysis in myocardial infarction (TIMI) and the rate of no-reflow during the operation were observed.The levels of N terminal type B natriuretic peptide (NT-proBNP) and cardiac function index [left ventricular end-diastolic diameter (LVEDD),left ventricular end-systolic diameter (LVESD),and left ventricular ejection fraction (LVEF)] of the two groups before operation and 3 d,1 month,3 months,and 6 months after operation were compared.The incidence of adverse reactions during the treatment and the incidence of cardiovascular events within 1 year after the operation were observed in the two groups.Results The rate of no-reflow in the intensive-dose group was 12.50％,which was significantly lower than that (31.25％) in the routine-dose group (P ＜ 0.05).The level of serum NT-proBNP and the LVEF in the two groups at 3 d,1 month,3 months,and 6 months after operation were significantly higher than those before operation (both P ＜ 0.05).The level of serum NT-proBNP,LVEDD,and LVESD decreased,but LVEF increased in the intensive-dose group at 3 and 6 months after operation as compared with those in the routine-dose group (all P ＜ 0.05).The adverse reaction rate was 4.17％ in the routinedose group,versus 8.33％ in the intensive-dose group;after 1-vear follow-up,the incidence of cardiovascular events was 2.08％ in the intensive-dose group,which was lower than that (8.33％) of the routine-dose group;no statistical differences were found between these two groups (both P ＞ 0.05).Conclusion The preoperative oral administration of 80 mg intensive-dose atorvastatin can reduce the rate of no-reflow after PCI,promote the recovery of cardiac function,and improve the prognosis of patients with acute myocardial infarction.关键词
心肌梗死/阿托伐他汀/经皮冠状动脉介入/心功能/无复流/预后Key words
myocardial infarction/atorvastatin/percutaneous coronary intervention/cardiac function/no-reflow/pragnosis分类
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劳翼,张劲,冯力,袁勇,张励庭,黄炫生,李明星..术前强化剂量阿托伐他汀口服对心肌梗死患者PCI术后无复流、心功能及预后的影响[J].山东医药,2018,58(6):19-23,5.
