CAJ | 학술논문

目的：探讨急性心肌梗死患者急诊经皮冠脉介入治疗(PCI)术前高剂量瑞舒伐他汀对心肌灌注和预后的影响。方法选择2013年1月~2014年12月在首都医科大学大兴医院就诊的急性ST段抬高型心肌梗死患者145例为研究对象，根据急诊PCI术前是否服用高剂量瑞舒伐他汀将患者分为常规治疗组(70例)和高剂量瑞舒伐他汀组(75例)。在急诊PCI术后两组患者均给予冠心病二级预防治疗，其中瑞舒伐他汀钙均给予10 mg，每晚1次。高剂量瑞舒伐他汀组在此基础上给予高剂量瑞舒伐他汀20 mg顿服。采用心肌灌注呈色分级(MBG)评价心肌灌注情况。并对患者进行随访，了解患者主要不良心脏事件(包括再发心肌梗死、心力衰竭、心源性死亡)的发生情况。结果高剂量瑞舒伐他汀组患者急诊PCI术后MBG 3级患者明显多于常规治疗组(53.3%比30.0%)(P<0.05)。而MBG 0~1级患者少于常规治疗组(12.0%比21.4%)(P<0.05)。高剂量瑞舒伐他汀组患者随访期间主要不良心脏事件的发生率低于常规治疗组(9.3%比22.9%)(P<0.05)。结论急性心肌梗死患者急诊PCI术前高剂量瑞舒伐他汀治疗可以改善患者的心肌灌注和预后。
목적：탐토급성심기경사환자급진경피관맥개입치료(PCI)술전고제량서서벌타정대심기관주화예후적영향。방법선택2013년1월~2014년12월재수도의과대학대흥의원취진적급성ST단태고형심기경사환자145례위연구대상，근거급진PCI술전시부복용고제량서서벌타정장환자분위상규치료조(70례)화고제량서서벌타정조(75례)。재급진PCI술후량조환자균급여관심병이급예방치료，기중서서벌타정개균급여10 mg，매만1차。고제량서서벌타정조재차기출상급여고제량서서벌타정20 mg돈복。채용심기관주정색분급(MBG)평개심기관주정황。병대환자진행수방，료해환자주요불양심장사건(포괄재발심기경사、심력쇠갈、심원성사망)적발생정황。결과고제량서서벌타정조환자급진PCI술후MBG 3급환자명현다우상규치료조(53.3%비30.0%)(P<0.05)。이MBG 0~1급환자소우상규치료조(12.0%비21.4%)(P<0.05)。고제량서서벌타정조환자수방기간주요불양심장사건적발생솔저우상규치료조(9.3%비22.9%)(P<0.05)。결론급성심기경사환자급진PCI술전고제량서서벌타정치료가이개선환자적심기관주화예후。
Objective To investigate effects of high-dose rosuvastatin treatment of patients with acute myocardial in-farction before emergency percutaneous coronary intervention on myocardial perfusion and prognosis. Methods 145 pa-tients with acute ST segment elevation myocardial infarction hospitalized in Daxing Hospital of the Capital Medical University from January 2013 to December 2014 were selected. According to whether taking high-dose rosuvastatain before emergency PCI, they were divided into conventional therapy group (70 cases) and high dose rosuvastatain group (75 cases). All patients were given secondary prevention of coronary heart disease treatment after emergency PCI, and rosuvastatain was registered 10 mg per night. On this basis, high-dose rosuvastatain was administered 20 mg at draught on high dose rosuvastatain group. Myocardial perfusion was evaluated by myocardial perfusion blush grade (MBG). And patients were followed up. The main adverse cardiac events including recurrent myocardial infarction, heart failure and cardiac death were recorded. Results The proportion of MBG 3 patients after primary PCI was higher in high-dose ro-suvastatin group than that in conventional therapy group (53.3% v s 30.0%), (P< 0.05). The proportion of MBG 0-1 patients was lower in high-dose rosuvastatin group (12.0% v s 21.4%), (P< 0.05). The incidence of main adverse car-diac events was lower in high-dose rosuvastatin group than that in conventional therapy group (9.3.% v s 22.9%), (P<0.05). Conclusion High-dose rasuvastatin treatment of patients with acute myocardial infarction before emergency PCI can improve myocardial perfusion and prognosis.