本文關(guān)鍵詞： 辛伐他汀 負(fù)荷劑量 急性心肌梗死 經(jīng)皮冠狀動(dòng)脈介入治療 圍手術(shù)期　出處：《中國(guó)藥房》2017年06期 　論文類型：期刊論文

【摘要】：目的:探討負(fù)荷劑量辛伐他汀對(duì)急性心肌梗死患者急診經(jīng)皮冠狀動(dòng)脈介入(PCI)治療圍術(shù)期相關(guān)指標(biāo)的影響。方法:回顧性收集急診行PCI治療的203例急性心肌梗死患者資料,按照治療方案的不同分為觀察組(102例)和對(duì)照組(101例)。對(duì)照組患者在PCI術(shù)前3 d給予常規(guī)治療,包括口服阿司匹林腸溶片300 mg,qd+辛伐他汀片40 mg,qd,術(shù)后給予辛伐他汀片40 mg/d,qd,療程為4周。觀察組患者于PCI術(shù)前2 h頓服辛伐他汀片80 mg,其他治療方法均與對(duì)照組相同。觀察并記錄兩組患者手術(shù)前后24 h總膽固醇(TC)、三酰甘油(TG)、低密度脂蛋白膽固醇(LDL-C)、高密度脂蛋白膽固醇(HDL-C)、白細(xì)胞介素6(IL-6)、IL-10、腫瘤壞死因子α(TNF-α)、血漿超敏肌鈣蛋白(TNT-HSST)、肌酸激酶同工酶(CKMB)、超敏C反應(yīng)蛋白(hs-CRP)水平,記錄治療期間不良反應(yīng)發(fā)生情況。同時(shí),隨訪術(shù)后30 d心血管主要不良事件(MACE)和造影劑腎病(CIN)發(fā)生情況。結(jié)果:兩組患者治療前后TG、TC、LDL-C、HDL-C水平比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。治療前,兩組患者TNF-α、IL-6、IL-10、hs-CRP、CKMB、TNT-HSST水平比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。治療后,兩組患者TNF-α、IL-6、hs-CRP、CKMB、TNT-HSST水平顯著高于同組治療前,且觀察組TNF-α、IL-6、hs-CRP水平顯著低于對(duì)照組,CKMB、TNT-HSST水平顯著高于對(duì)照組;兩組患者IL-10水平顯著低于同組治療前,但觀察組顯著高于對(duì)照組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。觀察組患者M(jìn)ACE和CIN發(fā)生率顯著低于對(duì)照組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。治療期間兩組患者均未見(jiàn)明顯不良反應(yīng)發(fā)生。結(jié)論:急性心肌梗死患者PCI圍術(shù)期使用負(fù)荷劑量辛伐他汀不僅能顯著降低患者TNF-α、IL-6和hs-CRP水平,升高CKMB、TNT-HSST和IL-10水平,還能降低術(shù)后MACE及CIN的發(fā)生率。
[Abstract]:Objective: To investigate the effects of simvastatin load dose on patients with acute myocardial infarction undergoing primary percutaneous coronary intervention (PCI) treatment of peri operative effect index. Methods: retrospectively collected emergency PCI treatment of 203 cases of acute myocardial infarction patients, according to different treatment regimens for the observation group (102 cases) and control group (in 101 cases). Patients in the control group PCI 3 D before surgery received conventional therapy, including oral Aspirin Enteric-coated Tablets 300 mg, Simvastatin Tablets qd+ 40 mg, QD, after giving Simvastatin Tablets 40 mg/d, QD, for 4 weeks. Patients in the observation group before PCI 2 h orally 80 Simvastatin Tablets mg, other treatments are the same with the control group. Observe and record the two groups of patients before and after surgery 24 h total cholesterol (TC), three glycerol (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), interleukin 6 (IL-6), IL-10 (tumor necrosis factor alpha TNF-偽),琛，

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