论文部分内容阅读
目的探讨急性心肌梗死经皮冠状动脉介入治疗(PCI)术后患者给予大剂量阿托伐他汀治疗对血清基质金属蛋白酶9(MMP-9)、高敏C反应蛋白(hs-CRP)水平及左心房功能的影响。方法将64例确诊为急性心肌梗死、PCI术后存活患者随机分为常规剂量阿托伐他汀治疗组和大剂量阿托伐他汀治疗组,每组32例。大剂量组术前给予阿托伐他汀80 mg负荷量口服,术后再予40 mg/晚维持4周,后改为20 mg/晚;常规剂量组予20 mg/晚治疗。分别于术前、术后1周、术后12周采用ELISA法测定MMP-9、hs-CRP水平,超声检测左心房功能。结果大剂量阿托伐他汀组较常规剂量组能更进一步降低血脂,在PCI手术前两组MMP-9、hs-CRP水平均明显高于正常水平,治疗后均迅速下降,1周时大剂量组MMP-9、hs-CRP水平显著低于常规剂量组,12周后两组间差异无统计学意义(P>0.05)。大剂量组1周时左心房主动收缩排空分数(LAAEF)较常规治疗组高(P<0.05);术后12周时大剂量组左心室舒张末期容积(LVEDV)、左心房主动收缩排空容积(LAAE)、LAAEF与常规治疗组比较差异均有统计学意义(P<0.05)。结论急性心肌梗死PCI术后患者给予大剂量阿托伐他汀治疗可进一步降低MMP-9、hs-CRP水平,改善左心房功能。
Objective To investigate the effects of high-dose atorvastatin on serum levels of matrix metalloproteinase-9, hs-CRP and left atrium in patients with acute myocardial infarction after percutaneous coronary intervention (PCI) Effect of function. Methods Sixty-four patients with acute myocardial infarction who were diagnosed as acute myocardial infarction were randomly divided into routine dose atorvastatin group and high dose atorvastatin group, 32 in each group. Atorvastatin 80 mg was orally administered to the high-dose group preoperatively, 40 mg / night postoperatively for 4 weeks, then 20 mg / night, and the conventional dose of 20 mg / night. The levels of MMP-9 and hs-CRP were measured by ELISA before surgery, 1 week after surgery and 12 weeks after surgery. The left atrial function was measured by ultrasound. Results The high-dose atorvastatin group could further lower the blood lipid level compared with the conventional dose group. The levels of MMP-9 and hs-CRP in the two groups before PCI were significantly higher than those in the normal group, and rapidly decreased after treatment. At 1 week, The levels of MMP-9 and hs-CRP in the two groups were significantly lower than those in the conventional dose group. There was no significant difference between the two groups after 12 weeks (P> 0.05). In the high-dose group, LAAEF was higher in the left atrium than that in the conventional treatment group at 1 week (P <0.05); at the 12th week, the left ventricular end-diastolic volume (LVEDV), left atrial active contraction Volume (LAAE), LAAEF compared with the conventional treatment group were statistically significant (P <0.05). Conclusions High-dose atorvastatin in patients with acute myocardial infarction after PCI can further reduce the levels of MMP-9, hs-CRP and improve left atrial function.