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PCI术前应用负荷剂量瑞舒伐他汀对急性NSTEMI患者再灌注心律失常的影响
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| 篇名： | PCI术前应用负荷剂量瑞舒伐他汀对急性NSTEMI患者再灌注心律失常的影响 |
| TITLE： | |
| 摘要： | 目的：探讨早期经皮冠状动脉介入治疗（PCI）术前应用负荷剂量瑞舒伐他汀对急性非ST段抬高型心肌梗死（NSTEMI）患者再灌注心律失常的影响。方法：136例急性NSTEMI患者随机分为负荷剂量组（68例）和对照组（68例）。两组中未服用抗血小板药物的患者入院后即刻给予负荷剂量阿司匹林肠溶片300 mg+硫酸氢氯吡格雷片600 mg；以往常规服用阿司匹林者入院后仅给予1次负荷剂量硫酸氢氯吡格雷片600 mg，常规服用氯吡格雷者入院后仅给予1次负荷剂量阿司匹林肠溶片300 mg。服药后12～24 h行PCI术。PCI术后，终身服用阿司匹林肠溶片100 mg+至少服用12个月硫酸氢氯吡格雷片75 mg。负荷剂量组患者于术前12 h口服负荷剂量瑞舒伐他汀钙片20 mg。所有患者于PCI术后当晚开始服用瑞舒伐他汀钙片10 mg，每日1次。观察两组患者冠状动脉造影情况、再灌注心律失常发生情况，手术前后肌酸激酶同工酶（CK-MB）、肌钙蛋白T（cTnT）水平及主要不良心血管事件。结果：两组患者病变血管数、罪犯血管数、罪犯血管狭窄程度、主要不良心血管事件发生率比较，差异均无统计学意义（P＞0.05）。负荷剂量组患者再灌注心律失常发生率显著低于对照组，差异有统计学意义（P＜0.01）。两组再灌注心律失常患者罪犯血管狭窄程度比较，差异无统计学意义（P＞0.05）。术前，两组患者CK-MB、cTnT水平比较，差异均无统计学意义（P＞0.05）；术后，两组患者 CK-MB、cTnT水平均显著高于同组术前，但负荷剂量组显著低于对照组，差异均有统计学意义（P＜0.01）。结论：PCI术前应用负荷剂量瑞舒伐他汀可降低急性NSTEMI患者再灌注心律失常发生率。 |
| ABSTRACT： | OBJECTIVE： To investigate the effects of loading-dose rosuvastain before early percutaneous coronary intervention （PCI） on reperfusion arrhythmias in patients with acute non-ST-segment elevation myocardial infarction （NSTEMI）. METHODS： A total of 136 patients with NSTEMI were randomly divided into loading-dose group （68 cases） and control group （68 cases）. Both groups who were not given anti-platelet drugs were given loading-dose of Aspirin enteric-coated tablets 300 mg+Clopidogrel sulfate tablets 600 mg immediately after admission. The patients who were given aspirin regularly were given loading-dose of Clopidogrel sulfate tablets 600 mg only once after admission. The patients who were given clopidogrel regularly were given loading-dose of Aspirin enteric-coated tablets 300 mg only once. Those received PCI 12-24 h after medication. After PCI， they took Aspirin enteric-coated tablets 100 mg for life+Clopidogrel bisulfate tablets 75 mg at least 12 months. Loading-dose group was given loading-dose of Rosuvastatin calcium tablets 20 mg orally， 12 h before surgery. All patients began to take Rosuvastatin calcium tablets 10 mg， once a day， since the night after the operation. Coronary angiography and the occurrence of reperfusion arrhythmia were observed in 2 groups. The levels of CK-MB and cTnT， major adverse cardiovascular events （MACE） were observed before and after surgery. RESULTS： There was no statistical significance in the number of diseased vessels， culprit vessels， the degree of culprit vessels stenosis or the incidence of MACE between 2 groups （P＞0.05）. The incidence of reperfusion arrhythmia in loading-dose group was significantly lower than control group， with statistical significance （P＜0.01）. There was no statistical significance in the degree of culprit vessels stenosis between 2 groups （P＞0.05）. Before surgery， there was no statistical significance in the levels of CK-MB or cTnT between 2 groups （P＞0.05）. After surgery， the levels of CK-MB and cTnT in 2 groups were significantly higher than before surgery， but the loading-dose group was significantly lower than the control group， with statistical significance （P＜0.01）. CONCLUSIONS： Preoperative loading-dose of rosuvastatin before PCI can reduce the incidence of reperfusion arrhythmias in NSTEMI patients. |
| 期刊： | 2017年第28卷第36期 |
| 作者： | 李宏松，许向东，吴国林，张方亮，张莉，陈霞，陈颖敏 |
| AUTHORS： | LI Hongsong，XU Xiangdong，WU Guolin，ZHANG Fangliang，ZHANG Li，CHEN Xia，CHEN Yingmin |
| 关键字： | 瑞舒伐他汀；非ST段抬高型心肌梗死；急性；再灌注心律失常；经皮冠状动脉介入治疗 |
| KEYWORDS： | Rosuvastatin； Non-ST-segment elevation myocardial infarction； Acute； Reperfusion arrhythmia； Percutaneous coronary intervention |
| 阅读数： | 320 次 |
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