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目的:探讨早期应用阿托伐他汀对急性ST段抬高心肌梗死(STEMI)患者梗死相关血管再通(PCI)后心肌微循环灌注的影响。方法:符合研究标准的87例STEMI患者,按梗死前应用他汀类药物的情况分为4组:A组(21例)应用他汀类药物>6个月;B组(25例)应用他汀类药物36个月;C组(18例)应用他汀类药物<3个月;D组(23例)未应用他汀类药物。所有患者均于急诊PCI后常规给予药物治疗,并于第21天行单光子发射型计算机断层心肌灌注显像(SPECT)。结果:A组和B组的心肌灌注积分、左室舒张末容积(LVEDV)和左室收缩末容积(LVESV)均明显低于D组(P<0.05),而左室射血分数(LVEF)明显高于D组(P<0.05)。C组的心肌灌注积分、LVEDV、LVESV也低于D组,但差异无统计学意义(P>0.05)。A组的心肌灌注积分、LVEDV、LVESV均明显低于B组(P<0.05),LVEF明显高于B组(P<0.05)。结论:长期小剂量应用阿托伐他汀可以改善STEMI患者急诊PCI后的心肌微循环灌注。
Objective: To investigate the effect of early use of atorvastatin on myocardial microcirculation perfusion after infarction-related revascularization (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: Eighty-seven STEMI patients were divided into 4 groups according to statin use before infarction: group A (21 patients) received statin> 6 months; group B (25 patients) received statin 36 months; Group C (n = 18) received statin <3 months; Group D (n = 23) did not receive statin. All patients were given routine medical therapy after emergency PCI and performed single photon emission computed tomography myocardial perfusion imaging (SPECT) on day 21. Results: Myocardial perfusion score, left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV) in group A and group B were significantly lower than those in group D (P <0.05) Significantly higher than the D group (P <0.05). The myocardial perfusion score, LVEDV and LVESV in group C were also lower than those in group D, but the difference was not statistically significant (P> 0.05). The myocardial perfusion score, LVEDV and LVESV in group A were significantly lower than those in group B (P <0.05), and LVEF was significantly higher in group A than that in group B (P <0.05). Conclusion: Long-term and low-dose atorvastatin can improve myocardial microcirculation perfusion in STEMI patients after emergency PCI.