短期大剂量阿托伐他汀对初发急性前壁心肌梗死患者左心室重构的影响

刘智坚; 胡高频; 费美莹; 殷召; 时全星; 孙飞

doi:10.24920/11810

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短期大剂量阿托伐他汀对初发急性前壁心肌梗死患者左心室重构的影响

Chinese Medical Sciences Journal 2018年33卷第2期页码：84-90

Original Article | Updated：2024-04-10

- 短期大剂量阿托伐他汀对初发急性前壁心肌梗死患者左心室重构的影响
- Affiliations：
  
  1 Department of Cardiology, the 210th Hospital of People’s Liberation Army, Dalian, Liaoning 116021, China;
  2 Department of Cardiology, the 306th Hospital of People’s Liberation Army, Beijing 100101, China;
- Author bio：
  
  * E-mail: doufangjie@126.com
- Funds：
- DOI：10.24920/11810
  中图分类号：
- 收稿日期：2017-11-07，
  
  网络出版日期：2018-06-20，
  
  纸质出版日期：2018-06-20
- Accepted：
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刘智坚, 胡高频, 费美莹, 等. 短期大剂量阿托伐他汀对初发急性前壁心肌梗死患者左心室重构的影响[J]. Chinese Medical Sciences Journal, 2018,33(2):84-90.

Liu Zhijian, Hu Gaopin, Fei Meiying, et al. Effects of Short-term High Dose Atorvastatin on Left Ventricular Remodeling in Patients with First Time Attack of Anterior Acute Myocardial Infarction[J]. Chinese medical sciences journal, 2018, 33(2): 84-90.
刘智坚, 胡高频, 费美莹, 等. 短期大剂量阿托伐他汀对初发急性前壁心肌梗死患者左心室重构的影响[J]. Chinese Medical Sciences Journal, 2018,33(2):84-90. DOI： 10.24920/11810.

Liu Zhijian, Hu Gaopin, Fei Meiying, et al. Effects of Short-term High Dose Atorvastatin on Left Ventricular Remodeling in Patients with First Time Attack of Anterior Acute Myocardial Infarction[J]. Chinese medical sciences journal, 2018, 33(2): 84-90. DOI： 10.24920/11810.

摘要

目的

评估短期大剂量阿托伐他汀治疗对初发前壁心肌梗死患者高敏C反应蛋白（hs-CRP）

丙二醛（MDA）、内皮素（ET-1）

基质金属蛋白酶（MMPs）及左心室重构的影响。

方法

103例成功施行经皮冠脉介入治疗（PCI）的初发前壁心肌梗死的住院患者随机分为两组：强化治疗组（n=49）入院后即给予阿托伐他汀40mg/日

维持1周

其后给予20mg/日;标准治疗组（n=54）给予阿托伐他汀20mg/日。在入院时、发病1周、2周及6个月随访时分别检测血浆hs-CRP

MDA

ET-1

MMP-2 和 MMP-9水平。在入院时、发病2周及1年随访时分别进行彩色超声心动检查评估左室舒张末容积（LVEDV）、左室收缩末容积（LVESV）和左室射血分数（LVEF）。比较上述实验室指标和左心室重构指标在强化治疗组和标准治疗组之间的差异。

结果

在心肌梗死发病后一周时强化治疗组血浆 hs-CRP（F=7.718

=0.009）、ET-1（

=7.882

=0.006）、MMP-9（F=4.834

=0.028）和pro-BNP(

=4.603

=0.032)的浓度明显低于标准治疗组;随访1年时两组患者的左室重构指标LVEDV（

=0.722

=0.444）

LVESV（

=1.228

=0.221）和LVEF（

=1.354

=0.187）值无明显差异。

结论

心肌梗死后给予短期大剂量阿托伐他汀可以有效降低血中hs-CRP、ET-1和MMP-9的水平

但对左室重构并无明显影响。

Abstract

Objects

The aim of this trial was to evaluate the effect of short-term high-dose atorvastatin therapy on levels of high-sensitivity C-reactive protein (hs-CRP)

malonaldehyde (MDA)

endothelin-1(ET-1)

matrix metalloproteinases (MMPs)

and left ventricular (LV) remodeling in patients with first time attack of acute anterior myocardial infarction (AAMI) .

Methods

A hundred and three patients with first time attack of AAMI who underwent successful primary percutaneous coronary intervention were randomized to receive atorvastatin 40 mg once daily for 1 week followed by 20 mg once daily (intensive treatment group

IT group

=49)

or atorvastatin 20 mg once daily (standard treatment group

ST group

=54). Plasma levels of hs-CRP

MDA

ET-1

MMP-2 and MMP-9 were measured on admission

at 1 week

2 weeks and 6 months follow up and compared between the IT group and ST group. Echocardiography was performed on admission

at 2 week

and 1 year follow up. The left ventricular end-diastolic volume (LVEDV)

left ventricular end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF) were measured at each echocardiographic examination and compared between the IT group and ST group.

Results

Plasma levels of hs-CRP (

=7.718

=0.009)

ET-1 (

=7.882

=0.006)

MMP-9 (

=4.834

=0.028) and pro-BNP (

=4.603

=0.032) were significantly lower at 1 week after initial onset of AAMI in the IT group compared with the ST group. The changes of LVEDV

LVESV

and LVEF at the 1 year follow-up from the admission did not differ between the IT group and the ST group (

=0.722

=0.444;

=1.228

=0.221;

=1.354

=0.187

repectively).

Conclusions

Short-term high-dose atorvastatin treatment for AAMI was associated with lower hs-CRP

ET-1 and MMP-9 levels compared to the standard dose treatment. However

this beneficial effect is not likely to related to the left ventricular remodeling.

关键词

Keywords

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