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 |
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).
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 factors[interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP)], myocardial injury markers[creatine kinase isoenzyme (CK-MB), cardiac troponin T (cTnT), N-terminal pro-brain natriuretic peptide (NT-proBNP)], cardiac function indicators[left 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.
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).
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.
[1] |
刘军, 贾志, 霍立巍. 非ST段抬高型急性心肌梗死患者经皮冠状动脉介入治疗术后高残留血小板活性与血小板表面Ⅱb/Ⅲa受体、P-选择素及预后的关系[J]. 实用医学杂志, 2022, 38(8): 934-937. https://www.cnki.com.cn/Article/CJFDTOTAL-SYYZ202208004.htm
|
[2] |
刘冉, 王宗方, 杨洋, 等. 冠状动脉内注射重组人尿激酶原治疗急性ST段抬高型心肌梗死的疗效[J]. 西北药学杂志, 2023, 38(4): 174-178. doi: 10.3969/j.issn.1004-2407.2023.04.031
|
[3] |
吴晴晴, 闫蕊, 郭明, 等. 糖尿病病程对急性ST段抬高型心肌梗死患者行经皮冠状动脉介入治疗后冠状动脉微血管阻塞及近期预后的影响[J]. 中国心血管病研究, 2023, 21(6): 511-517. doi: 10.3969/j.issn.1672-5301.2023.06.006
|
[4] |
王琰, 李永星, 郭华, 等. 半剂量替罗非班辅助经皮冠状动脉介入术治疗老年急性ST段抬高心肌梗死患者的临床研究[J]. 中国现代医学杂志, 2022, 32(5): 70-74. doi: 10.3969/j.issn.1005-8982.2022.05.012
|
[5] |
叶靖, 晏花龙. 早期应用替罗非班对急性ST段抬高型心肌梗死患者行急诊经皮冠状动脉介入术疗效影响研究[J]. 山西医药杂志, 2021, 50(13): 2076-2078. doi: 10.3969/j.issn.0253-9926.2021.13.022
|
[6] |
张芸楠, 穆煜, 林阳, 等. 瑞舒伐他汀或阿托伐他汀对经皮冠状动脉介入治疗术后患者血脂的影响[J]. 中国临床药理学杂志, 2020, 36(17): 2614-2616. https://www.cnki.com.cn/Article/CJFDTOTAL-GLYZ202017005.htm
|
[7] |
中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 急性ST段抬高型心肌梗死诊断和治疗指南[J]. 中华心血管病杂志, 2010, 38(8): 675-690. doi: 10.3760/cma.j.issn.0253-3758.2010.08.002
|
[8] |
陈晓敏, 葛广豪, 曹华, 等. 冠脉内逆向应用重组人尿激酶原溶栓联合PCI对急性ST段抬高型心肌梗死患者预后的临床研究[J]. 临床心血管病杂志, 2022, 38(6): 489-494. https://www.cnki.com.cn/Article/CJFDTOTAL-LCXB202206010.htm
|
[9] |
WANG Y L, YANG Q, HU C Y, et al. Efficacy of comprehensive remote ischemic conditioning in elderly patients with acute ST-segment elevation myocardial infarction underwent primary percutaneous coronary intervention[J]. J Geriatr Cardiol, 2022, 19(6): 435-444.
|
[10] |
李子文, 王德华, 张亚运, 等. 冠状动脉解剖评分系统在急性ST段抬高型心肌梗死患者微血管阻塞中的预测价值[J]. 实用放射学杂志, 2023, 39(5): 745-749. doi: 10.3969/j.issn.1002-1671.2023.05.014
|
[11] |
TAN J, ZHANG Y H, SI J, et al. Incidence, predictors and prognosis of acute kidney injury in acute ST-segment elevation myocardial infarction patients undergoing emergent coronary angiography/primary percutaneous coronary intervention[J]. J Geriatr Cardiol, 2023, 20(2): 139-149. doi: 10.26599/1671-5411.2023.02.004
|
[12] |
郭志斌, 吴春芳, 刘子洪, 等. 辛伐他汀可刺激骨髓间充质干细胞的成骨分化[J]. 中国组织工程研究, 2021, 25(19): 2963-2968. doi: 10.3969/j.issn.2095-4344.3531
|
[13] |
葛广豪, 龚勇, 马江伟, 等. 不同负荷剂量他汀类药物对老年急性心肌梗死直接介入治疗术后心肌细胞的影响[J]. 中华老年心脑血管病杂志, 2016, 18(9): 899-904. doi: 10.3969/j.issn.1009-0126.2016.09.002
|
[14] |
赵晨宇, 罗晓康, 段亚冰, 等. 冠状动脉搭桥术后患者应用中等剂量瑞舒伐他汀和辛伐他汀的疗效及安全性比较[J]. 吉林大学学报: 医学版, 2021, 47(2): 477-482. https://www.cnki.com.cn/Article/CJFDTOTAL-BQEB202102029.htm
|
[15] |
王志刚, 朱长乐, 陈信义, 等. 健脾益气摄血方及其拆方对辛伐他汀诱导斑马鱼肝脏出血防治作用研究[J]. 世界中西医结合杂志, 2022, 17(7): 1308-1312. https://www.cnki.com.cn/Article/CJFDTOTAL-SJZX202207007.htm
|
[16] |
王文丰, 孙历贤, 巨名飞, 等. 不同剂量辛伐他汀对老年T2DM患者急性心肌梗死PCI术后心功能及预后的影响[J]. 山东医药, 2016, 56(46): 76-78. doi: 10.3969/j.issn.1002-266X.2016.46.023
|
[17] |
付学伟, 万云高, 王慧娟, 等. 对比分析他汀类药物依从性对心肌梗死及脑梗死患者预后的影响[J]. 中国循证心血管医学杂志, 2020, 12(7): 877-881. doi: 10.3969/j.issn.1674-4055.2020.07.26
|
[18] |
毛洪宾, 宋丽丽, 王立旗. 不同他汀类药物对老年急性心肌梗死患者血清相关因子水平及心功能的影响[J]. 华夏医学, 2021, 34(3): 17-21. https://www.cnki.com.cn/Article/CJFDTOTAL-GLYX202103006.htm
|
[19] |
余晓伊, 格日勒. 不同他汀类药物对急性心肌梗死患者血管内皮功能、心脏功能的影响[J]. 中国现代医生, 2020, 58(6): 90-93. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYS202006024.htm
|
1. |
吴瑞英,王磊,杨知山,杨顶权. 雄激素性秃发的治疗进展. 武汉大学学报(医学版). 2023(01): 29-35 .
![]() | |
2. |
夏继宁,项晶. 透骨草-侧柏叶煎剂治疗雄激素性秃发的疗效及对患者焦虑与抑郁水平的影响. 中华全科医学. 2023(01): 123-126 .
![]() |