【摘要】 目的研究不同剂量阿托伐他汀对急性心肌梗死循环内皮祖细胞(EPCs)的作用,以及对延迟开通冠状动脉时手术并发症的影响。方法选择住院未溶栓治疗的急性心肌梗死患者90例,随机分为3组:A组33例,B组28例,C组29例。入院时在常规药物治疗基础上,A组给予阿托伐他汀10mg,每晚睡前口服;B组给予阿托伐他汀20mg,每晚睡前口服;C组给予托伐他汀40mg,每晚睡前口服,1周后行延迟冠状动脉介入手术治疗(延迟PCI)。采用流式细胞仪技术测定各组入院时、术前即刻和术后12小时循环内皮祖细胞的数量水平,并观察各组延迟PCI术中严重并发症(无复流、慢血流、心律失常、急性血栓、持续性低血压、死亡等)发生情况。结果①急性心肌梗死行延迟PCI患者,术前尽早给予"强化剂量"的阿托伐他汀(40mg),与"常规剂量"阿托伐他汀(20或10mg)比较,能够显著升高反映血管修复功能的循环内皮祖细胞水平,这一变化在延迟PCI术后12小时仍然可见。②"强化剂量"的阿托伐他汀使延迟PCI术中慢血流、无复流、心律失常、急性血栓、持续性低血压、死亡等严重并发症发生率下降。结论急性心肌梗死延迟PCI术前尽早给予"强化剂量"的阿托伐他汀能显著升高循环内皮祖细胞水平,使术中严重急性并发症发生率下降,且不良反应无明显增加。更多还原

【Abstract】 Objective To study the function of circulating endothelial progenitor cells(EPCs) with different doses of atorvastatin on patients with acute myocardial infarction,as well as the effects of complications.Methods 90 patients of coronary artery without thrombolytic treatment were randomly divided into three groups(A group 33 cases;B group 29 cases;C group 28 cases).On the basis of conventional drug treatment,A group atorvastatin 10 mg qn,B group atorvastatin 20 mg qn,C group atorvastatin 40 mg qn,undergoing treatment of delayed percutaneous coronary intervention(delayed PCI) after 1 week.Detecting the number of circulating endothelial progenitor cells to each group in admission,preoperative and postoperative 12 hour with flow cytometric,and observating severe complications in the delayed PCI to each group(no reflow,slow blood flow,cardiac arrhythmia,acute thrombosis,persistent hypotension,death,etc).Results(1) Patients with acute myocardial infarction in delayed PCI,comparing the "intensive dose" atorvastatin 40mg qn,and "regular doses" 20 or 10 mg in preoperative as early as possible,can significantly increase the number of circulating endothelial progenitor cells reflecting the level of vascular repair.The change is still visible in 12 hours after delayed PCI(2) The "intensive dose" atorvastatin decreased incidence of death and other serious complications in delays PCI,such as slow blood flow,in no reflow,arrhythmia,acute thrombosis,persistent low blood pressure.Conclusion The "intensive dose" atorvastatin can significantly increase the number of circulating endothelial progenitor cells on patients with acute myocardial infarction in delayed PCI in preoperative as early as possible,and decrease the incidence of severe acute complications in operative,and not significantly increase adverse reactions.更多还原