阿托伐他汀对急性心肌梗死患者择期PCI术后心肌灌注及心功能的影响

目的:探讨阿托伐他汀对急性心肌梗死患者择期介入治疗(PCI)后心肌灌注及心功能的影响。方法:选择在我院行择期PCI治疗的急性心肌梗死患者120例,随机分为阿托伐他汀组60(例)和对照组(60例)。阿托伐他汀组于PCI术前1周开始给予阿托伐他汀20mg每晚一次,观察阿托伐他汀组与对照组PCI术后15min校正的TIMI帧数计数(CTFC),同时行冠状动脉血流速度测定。术后2周行心肌核素显像分析,计算心肌灌注显像积分,应用QG SPECT软件再次处理,得到左室射血分数(LVEF)、左室收缩末期容积(LVESV)及左室舒张末期容积(LVEDV)等心功能指标。结果:阿托伐他汀组校正的TIMI帧数计数明显低于对照组(26.28!5.71)vs(35.12!6.18);冠状动脉血流速度高于对照组(151.23!36.7)mm/s vs(130.82!40.2)mm/s;阿托伐他汀组术后2周心肌灌注显像积分低于对照组(2.0!0.5)vs(3.5!0.6);左室射血分数明显高于对照组(0.58±0.05)vs(0.41±0.08);左室收缩末期容积、左室舒张末期容积低于对照组(56.6±1.4)mm vs(63.1±0.8)mm,(44.7±1.4)mm vs(52.8±2.5)mm,差异均有统计学意义。结论:急性心肌梗死患者择期PCI术前给予阿托伐他汀治疗可改善心肌灌注及心功能。

Effects of atorvastatin on improving myocardium reperfusion and heart function in patients with acute myocardial infarction after delayed percutaneous coronary intervention

Objective: To explore the effects of atorvastatin on myocardium reperfusion and heart function in patients with acute myocardial infarction after delayed percutaneous coronary intervention(PCI).Methods: 120 patients with acute myocardial infarction(AMI) were randomly divided into 2 groups,atorvastatin-treated group(60 cases) and routine-treated group(60 cases).The patients in the two groups were all received the coronary secondary prevention,the atorvastatin-treated group added atorvastatin(20mg,one time per day) on 7 days beforePCI.The corrected TIMI frame count(CTFC),coronary blood welocity were observed on 15minutes after PCI.Analysis of myocardial perfusion tomography in two patients was performed on 2 weeks after PCI.The indices of cardiac function in two groups including LVEF,LVEDD and LVESD were measured by QG SPECT soft.Results: The corrected TIMI frame count(CTFC)in atorvastatin-treated group were significantly lower than those in control group(26.28±5.71)vs(35.12±6.18),but coronary blood welocity in atorvastatin-treated group were significantly higher than those in control group(151.23±36.7)mm/s vs(130.82±40.2)mm/s.In atorvastatin-treated group,points of myocardial perfusion imaging(2.0±0.5)were significantly lower than those in routine-treated group(3.5±0.6).In atorvastatin-treated group,left ventricular end diastolic volume(56.6±1.4)and left ventricular end systolic volume(44.7±1.4)were all decreased while left ventricular ejection fraction(0.58±0.05)improved markedly than those in controls(0.41±0.08).Conclusion: Administration of atorvastatin before delayed PCI may significantly improve myocardial microvascular perfusion and cardiac function.