临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
2015年
12期
990-993
,共4页
张天鹏%刘冰%王国兴%张斌
張天鵬%劉冰%王國興%張斌
장천붕%류빙%왕국흥%장빈
ST段抬高型心肌梗死%阿托伐他汀%肿瘤坏死因子α%纤溶酶原激活物抑制剂1%自发再通
ST段抬高型心肌梗死%阿託伐他汀%腫瘤壞死因子α%纖溶酶原激活物抑製劑1%自髮再通
ST단태고형심기경사%아탁벌타정%종류배사인자α%섬용매원격활물억제제1%자발재통
ST elevation myocardial infarction%Atorvastatin%Tumor necrosis factor alpha%Plasminogen activator inhibitor 1%Spontane-ous recanalization
目的：明确急性心肌梗死（ AMI）后即刻给予阿托伐他汀预处理对于ST段抬高型心肌梗死（ STEMI）是否有益。方法共有149例接受急诊PCI的STEMI患者入选本研究。其中安慰剂组76例，80 mg阿托伐他汀组73例。分别于刚入急诊时、冠脉造影（ CAG）时和AMI后24 h测定肿瘤坏死因子（ TNF-α）、纤溶酶原激活物抑制剂（ PAI-1）、蛋白C（PC）、蛋白S（PS）、PCI前测定TIMI分级。AMI后24 h测定左室射血分数（LVEF）。结果刚入急诊、CAG时及AMI后24 h，阿托伐他汀组和安慰剂组之间的PS和PC水平无显著差异（ P >0.05）。在CAG时（ P =0.042）及AMI后24 h（ P =0.012），阿托伐他汀组的TNF-α显著低于安慰剂组及PAI-1（ P =0.004）。阿托伐他汀组的自发再通（SR）率（ P =0.035）及LVEF值（ P =0.018）显著高于安慰剂组（ P <0.05）。结论阿托伐他汀急诊预处理通过抑制TNF-α及PAI-1在AMI时的急性大量释放，能够明显增加AMI患者的SR发生率并能促进心功能恢复。
目的：明確急性心肌梗死（ AMI）後即刻給予阿託伐他汀預處理對于ST段抬高型心肌梗死（ STEMI）是否有益。方法共有149例接受急診PCI的STEMI患者入選本研究。其中安慰劑組76例，80 mg阿託伐他汀組73例。分彆于剛入急診時、冠脈造影（ CAG）時和AMI後24 h測定腫瘤壞死因子（ TNF-α）、纖溶酶原激活物抑製劑（ PAI-1）、蛋白C（PC）、蛋白S（PS）、PCI前測定TIMI分級。AMI後24 h測定左室射血分數（LVEF）。結果剛入急診、CAG時及AMI後24 h，阿託伐他汀組和安慰劑組之間的PS和PC水平無顯著差異（ P >0.05）。在CAG時（ P =0.042）及AMI後24 h（ P =0.012），阿託伐他汀組的TNF-α顯著低于安慰劑組及PAI-1（ P =0.004）。阿託伐他汀組的自髮再通（SR）率（ P =0.035）及LVEF值（ P =0.018）顯著高于安慰劑組（ P <0.05）。結論阿託伐他汀急診預處理通過抑製TNF-α及PAI-1在AMI時的急性大量釋放，能夠明顯增加AMI患者的SR髮生率併能促進心功能恢複。
목적：명학급성심기경사（ AMI）후즉각급여아탁벌타정예처리대우ST단태고형심기경사（ STEMI）시부유익。방법공유149례접수급진PCI적STEMI환자입선본연구。기중안위제조76례，80 mg아탁벌타정조73례。분별우강입급진시、관맥조영（ CAG）시화AMI후24 h측정종류배사인자（ TNF-α）、섬용매원격활물억제제（ PAI-1）、단백C（PC）、단백S（PS）、PCI전측정TIMI분급。AMI후24 h측정좌실사혈분수（LVEF）。결과강입급진、CAG시급AMI후24 h，아탁벌타정조화안위제조지간적PS화PC수평무현저차이（ P >0.05）。재CAG시（ P =0.042）급AMI후24 h（ P =0.012），아탁벌타정조적TNF-α현저저우안위제조급PAI-1（ P =0.004）。아탁벌타정조적자발재통（SR）솔（ P =0.035）급LVEF치（ P =0.018）현저고우안위제조（ P <0.05）。결론아탁벌타정급진예처리통과억제TNF-α급PAI-1재AMI시적급성대량석방，능구명현증가AMI환자적SR발생솔병능촉진심공능회복。
Objective To determine whether the emergent atorvastatin treatment just after the identification of acute myocardial infarction ( AMI)is beneficial to ST elevation myocardial infarction( STEMI)patients. Methods A total of 149 STEMI patients received primary PCI were selected into this study. 76 patients were randomized to placebo group. 73 patients received treatment with atorvastatin at the dose of 80 mg. The tumor necrosis factor alpha(TNF-α),plasminogen activator inhibitor 1(PAI-1),protein C(PC),protein S(PS)were assayed on the ad-mission,in the procedure of coronary angiography( CAG)and 24 h after AMI. TIMI grade were measured before PCI. The left ventricular ejection fraction( LVEF)was assessed 24 h after AMI. Results No significant differences existed in the PS and PC levels between atorvastatin and place-bo groups on the admission,in CAG and 24 h after AMI( P >0. 05). In CAG( P =0. 042)and 24 h after AMI( P =0. 012),a significantly lower TNF-αwere found in the atorvastatin group compared with placebo group. The PAI-1 level was significantly lower in the atorvastatin group compared with placebo group( P =0. 004). Atorvastatin group demonstrated higher incidence of spontaneous recanalization(SR)( P =0. 035) and high LVEF value( P =0. 018)than placebo group. Conclusion Emergent atorvastatin treatment significantly increase the incidence of SR in STEMI patients,which may be associated with the suppressing effects of atorvastatin on PAI-1 and TNF-α release in AMI.
