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目的观察急性心肌梗死急诊经皮冠状动脉介入(PCI)治疗前首次服用80mg阿托伐他汀能否预防术中无复流的发生及降低hs-CRP水平。方法 73例急性心肌梗死急诊PCI患者随机分为观察组(37例)及对照组(36例)。2组患者PCI术前均嚼服阿司匹林300mg,氯吡咯雷600mg。观察组予冠心病基础药物治疗,在PCI前首次给予负荷剂量阿托伐他汀80mg,后给予阿托伐他汀40mg/d;对照组仅予基础药物治疗,并给予阿托伐他汀40mg/d。观察PCI术中无复流的发生及术前、术后12hhs-CRP的变化。结果观察组术中无复流的发生率稍低于对照组(8.1%vs22.2%)但差异无统计学意义(P>0.05);术后12h阿托伐他汀组hs-CRP水平低于对照组[(10.29±9.15)vs(13.77±10.41)mg/L,P<0.01]。结论对于急性心肌梗死急诊PCI患者,介入术前首次给予负荷剂量的阿托伐他汀能够降低炎症反应,能否确实降低PCI术中无复流的发生有待进一步研究。
Objective To observe whether the first 80 mg atorvastatin before acute percutaneous coronary intervention (PCI) can prevent the occurrence of no-reflow and reduce the level of hs-CRP in patients with acute myocardial infarction. Methods Seventy-three acute myocardial infarction patients with acute PCI were randomly divided into observation group (37 cases) and control group (36 cases). Two groups of patients before chewing were premedication aspirin 300mg, clopidogrel 600mg. The patients in the observation group were treated with basic drugs of coronary heart disease. At first, 80 mg of atorvastatin loaded at a dose of 40 mg / d was given before the PCI. The control group was treated with atorvastatin 40 mg / d only. To observe the occurrence of no-reflow in PCI and the changes of 12 hhs-CRP before and after operation. Results The incidence of no-reflow in the observation group was slightly lower than that in the control group (8.1% vs 22.2%), but the difference was not statistically significant (P> 0.05). The level of hs-CRP in the atorvastatin group was lower than The control group [(10.29 ± 9.15) vs (13.77 ± 10.41) mg / L, P <0.01]. Conclusions Atorvastatin, the first dose of atorvastatin, can reduce the inflammatory response in patients with acute myocardial infarction (PCI) and can reduce the incidence of no-reflow in PCI.