大剂量阿托伐他汀对糖尿病急性前壁心肌梗死溶栓效果的影响

目的:观察尿激酶溶栓前口服大剂量阿托伐他汀对溶栓效果及近期左心室功能的影响。方法:连续收集糖尿病ST段抬高型急性前壁心肌梗死行溶栓治疗患者110例,随机分为阿托伐他汀治疗组(他汀组,60例)及常规治疗组(对照组,50例),他汀组溶栓前口服阿托伐他汀80 mg。2组患者溶栓前及溶栓后24 h检测血浆高敏C反应蛋白水平,溶栓前及1个月后行超声心动图检查。结果:他汀组溶栓再通率高于对照组(P<0.05);溶栓后24 h他汀组高敏C反应蛋白增高程度显著低于对照组(P<0.01)。溶栓后1个月,2组患者左心室舒张末期容积指数、收缩末期容积指数均较溶栓前明显升高,左心室射血分数均显著下降(P<0.01);但他汀组左心室射血分数下降程度明显低于对照组(P<0.01)。 结论:糖尿病急性前壁心肌梗死患者溶栓前口服大剂量阿托伐他汀可增加溶栓再通率,可能有助于延缓近期左心室功能的减退。

Effect of the high-does atorvastatin on the thrombolysis of acute anterior wall myocardial infarction in diabetic patients

Objective:To investigate the effects of the high-does atorvastatin before urokinase treatment on the thrombolysis and recently left ventricular function. Methods:One hundred and ten diabetic patients with acute anterior wall myocardial infarction were randomly divided into the atorvastatin treatment group ( 60 cases ) and routine treatment group ( 50 cases ) . The atorvastatin treatment group were treated with 80 mg by oral before urokinase thrombolysis. The serum levels of high sensitivity C reactive protein before thrombolysis and after 24 h of thrombolysis in two groups were measured. The echocardiography before thrombolysis and after 1 month of thrombolysis in two groups were detected. Results:The incidence of revascularization in the atorvastatin treatment group was higher than that in routine treatment group(P<0. 05). The increasing serum level of high sensitivity C reactive protein after 24 h of thrombolysis was significantly lower than that in control group(P <0. 01). Compared with before thrombolysis,the levels of left ventricular end diastolic volune index and left ventricular end systolic volune index in two groups significantly increased after 1 month of thrombolysis. Compared with before thrombolysis,the levels of left ventricular ejection fraction in two groups significantly decreased after 1 month of thrombolysis,the decreasing degree of which in the atorvastatin treatment group was significantly lower than that in routine treatment group(P <0. 01). Conclusions:The high-does atorvastatin by oral before thrombolysis can significantly improve the incidence of revascularization in diabetic patients with acute anterior myocardial infarction,and may retard the declining of left ventricular function.