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目的:探讨比较经皮冠状动脉介入(percutaneous coronary intervention,PCI)术前应用瑞舒伐他汀与辛伐他汀治疗急性心肌梗死(acute myocardial infarction,AMI)的近期疗效及预后。方法:120例符合纳入标准的行PCI术治疗的AMI患者按随机数字表法随机分为瑞舒伐他汀组(n=60)和辛伐他汀组(n=60)。PCI术前,常规治疗基础上,瑞舒伐他汀组给予瑞舒伐他汀治疗,辛伐他汀组给予辛伐他汀治疗。观察比较两组患者近期疗效。并随访6个月,比较组间预后及血浆氧化低密度脂蛋白(oxidized low density lipoprotein,OxLDL)、血清胱抑素C(cystatin C,Cys-C)水平。结果:治疗后,辛伐他汀组和瑞舒伐他汀组患者ST段回落>50%比率(93.3%vs 95.0%)、TIMI3级比率(91.7%vs 93.3%)、CK-MB峰值浓度(194.8±32.5vs 191.7±31.1U/L)、cTnI峰值浓度(2.66±0.43vs 2.55±0.26ng/ml)组间比较无统计学差异(P均>0.05)。随访6个月,瑞舒伐他汀组患者心血管不良事件总发生率明显低于辛伐他汀组(8.3%vs 28.3%,P<0.05)。与辛伐他汀组相比,瑞舒伐他汀组患者治疗后血浆OxLDL、血清Cys-C水平降低(295.1±56.2vs 316.8±60.5ug/L,0.62±0.07vs 0.71±0.09mg/L),组间比较都有统计学差异(P均<0.05)。结论:与PCI术前应用辛伐他汀组相比,应用瑞舒伐他汀能够更有效改善预后,并且能够显著降低OxLDL、Cys-C水平,临床上值得应用。
Objective: To investigate the short-term efficacy and prognosis of perioperative interventions of rosuvastatin and simvastatin in patients with acute myocardial infarction (AMI) before percutaneous coronary intervention (PCI). Methods: One hundred and twenty patients with AMI undergoing PCI were randomly divided into rosuvastatin group (n = 60) and simvastatin group (n = 60) according to the random number table method. On the basis of routine therapy, rosuvastatin was given to patients in rosuvastatin group and to simvastatin in simvastatin group. Observation and comparison of the two groups of patients with short-term efficacy. The patients were followed up for 6 months. The prognosis and plasma levels of oxidized low density lipoprotein (OxLDL) and serum cystatin C (Cys-C) were compared between the two groups. Results: After treatment, the ST-segment regression rates were> 50% (93.3% vs 95.0%), TIMI grade 3 (91.7% vs 93.3%) and CK-MB peak 32.5 vs 191.7 ± 31.1 U / L, respectively. There was no significant difference between the peak concentrations of cTnI (2.66 ± 0.43 vs 2.55 ± 0.26 ng / ml) (P all> 0.05). The 6-month follow-up showed that the overall incidence of adverse cardiovascular events was significantly lower in the rosuvastatin group than in the simvastatin group (8.3% vs 28.3%, P <0.05). Compared with the simvastatin group, the levels of plasma OxLDL and serum Cys-C were lower in the rosuvastatin group (295.1 ± 56.2 vs 316.8 ± 60.5ug / L, 0.62 ± 0.07 vs 0.71 ± 0.09 mg / L) Between the two groups were statistically significant (all P <0.05). Conclusions: Compared with simvastatin group before PCI, rosuvastatin can improve prognosis more effectively, and can significantly reduce the level of OxLDL and Cys-C, which is worthy of clinical application.