刘华, 张建刚, 李冰, 王德广, 马增才, 徐泽升. 不同剂量他汀类药物对经皮冠状动脉介入治疗的老年ST段抬高型急性心肌梗死患者的影响[J]. 实用临床医药杂志, 2024, 28(9): 62-66, 72. DOI: 10.7619/jcmp.20233696
引用本文: 刘华, 张建刚, 李冰, 王德广, 马增才, 徐泽升. 不同剂量他汀类药物对经皮冠状动脉介入治疗的老年ST段抬高型急性心肌梗死患者的影响[J]. 实用临床医药杂志, 2024, 28(9): 62-66, 72. DOI: 10.7619/jcmp.20233696
LIU Hua, ZHANG Jiangang, LI Bing, WANG Deguang, MA Zengcai, XU Zesheng. The impact of different dosages of statins in elderly patients with ST-segment elevation acute myocardial infarction undergoing percutaneous coronary intervention[J]. Journal of Clinical Medicine in Practice, 2024, 28(9): 62-66, 72. DOI: 10.7619/jcmp.20233696
Citation: LIU Hua, ZHANG Jiangang, LI Bing, WANG Deguang, MA Zengcai, XU Zesheng. The impact of different dosages of statins in elderly patients with ST-segment elevation acute myocardial infarction undergoing percutaneous coronary intervention[J]. Journal of Clinical Medicine in Practice, 2024, 28(9): 62-66, 72. DOI: 10.7619/jcmp.20233696

不同剂量他汀类药物对经皮冠状动脉介入治疗的老年ST段抬高型急性心肌梗死患者的影响

The impact of different dosages of statins in elderly patients with ST-segment elevation acute myocardial infarction undergoing percutaneous coronary intervention

  • 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。

     

    Abstract:
    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 factorsinterleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP), myocardial injury markerscreatine kinase isoenzyme (CK-MB), cardiac troponin T (cTnT), N-terminal pro-brain natriuretic peptide (NT-proBNP), cardiac function indicatorsleft 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-α decreased 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.

     

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