急性心肌梗死急诊介入治疗后辛伐他汀对早期左心室重构的影响

目的探讨急性心肌梗死(acute myocardial infarction,AMI)急诊直接PCI术后使用辛伐他汀对早期左心室重构的影响。方法选择AMI接受急诊直接PCI患者245例,随机分为辛伐他汀治疗组(治疗组)123例和对照组122例。比较2组术后即刻TIMI分级、计算校正TIMI计帧数(cTFC)和心肌Blush分级。采用彩色多普勒超声心动仪分别于发病早期(<24h)、1、2、3周末连续测量、计算左心室形态、构型等指标并进行分析。结果与基线比较,对照组1周末左心室收缩末内径(LVESD)、左心室短轴前半径(Ra)/内径(D)明显升高,2周末左心室舒张末内径(LVEDD)、LVESD、Ra/D、左心室前部心内膜弧长(ASL)、后部心内膜弧长(PSL)明显升高,3周末LVEDD、LVESD、Ra/D、ASL、PSL、LVEF明显升高,差异有统计学意义(P<0.05,P<0.01);治疗组2周末LVEDD、LVESD、PSL、LVEF明显升高,3周末LVEDD、LVESD、ASL、PSL、LVEF明显升高(P<0.05,P<0.01)。与对照组比较,治疗组2周末、3周末LVEDD、LVESD、Ra/D、ASL、PSL明显降低,LVEF明显升高,差异有统计学意义(P<0.05)。结论 AMI患者急诊直接PCI术后,使用辛伐他汀对早期左心室重构有抑制作用。

Effect of simvastatin on early left ventricular remodeling in acute myocardial infarction patients after emergency PCI

Objective To study the effect of simvastatin on early left ventricular remodeling in acute myocardial infarction(AMI) patients after emergency percutaneous coronary intervention(PCI).Methods Two hundred and forty-five AMI patients undergoing emergency PCI were randomly divided into simvastatin treatment group(n=123) and control group(n=122).Their TIMI grade,corrected TIMI frame count(cTFC) and myocardial blush grade were compared immediately after PCI.Indexes of left ventricular shape and geometry were measured by color Doppler echocardiography at <24 h and weekends 1,2 and 3,respectively.Results The LVESD and left ventricular Ra/D at weekend 1,the LVEDD,LVESD,left ventricular Ra/D,left ventricular ASL and PSL at weekends 2 and 3 were significantly higher than their baseline parameters in control group(P<0.05,P<0.01).The LVEDD,LVESD,left ventricular ASL and PSL at weekend 2 were significantly lower while the LVEDD,LVESD,left ventricular ASL and PSL,and LVEF at weekend 3 were significantly higher in simvastatin treatment group(P<0.05,P<0.01).The LVEDD,LVESD,left ventricular Ra/D,left ventricular ASL and PSL were significantly lower while the LVEF was significantly higher at weekends 2 and 3 in simvastatin treatment group than in control group(P<0.05).Conclusion Simvastatin can inhibit LVR in AMI patients after emergency PCI.