【摘要】 目的探讨大剂量阿托伐他汀对急性ST段抬高心肌梗死(STEMI)溶栓后左室收缩功能及血浆脑钠肽(BNP)水平影响。方法 80例接受急诊溶栓的急性ST段抬高心肌梗死(STEMI)患者分为他汀大剂量组(40例)和他汀常规剂量组(40例),他汀大剂量组在艾通立(rt-PA,50mg)溶栓前给予阿托伐他汀80mg顿服,溶栓后继续给予40mg/d,他汀常规剂量组溶栓前不使用他汀类药物,溶栓后给予20mg/d。二组患者均接受其他常规治疗。溶栓后24h内及1个月后应用电化学发光法测定检测血清脑钠肽(BNP)的水平。应用超声心动图检测二组患者的左室舒张末内径(LVEDd)、左室射血分数(LVEF)及左室短轴缩短率(LVFS)。结果 STEMI患者1个月后他汀大剂量组LVEDd显著低于他汀常规剂量组,LVEF和LVFS显著高于常规剂量组;STEMI患者在应用阿托伐他汀40mg和20mg治疗1个月时,血浆BNP与治疗前比较差异有统计学意义(P<0.01),且二组比较差异亦有统计学意义(P<0.05)。结论急诊行溶栓治疗的急性心肌梗死患者使用阿托伐他汀序贯治疗对心肌具有更强的保护作用,能够抑制AMI后的心室重塑,改善患者左心室功能,减少心衰发生,从而改善患者长期愈后,降低病死率。更多还原

【Abstract】 Objective To observe the effects of high dose of atorvastatin on left ventricular function of patients with acute ST-segement elevated myocardial infarction(STEM) after thrombolysis.Methods Eighty patients with acute ST-segement elevated myocardial infarction(STEM) were divided into two groups: high dosage treat group(n=40) and conventional treat group(n=40).The 50mg rt-PA was given before the patients in the high dosage treat group were administrated 80mg atorvastatin,and then 40mg/d for 1 month.While the patients in the conventional treat group were not given 80mg atorvastatin and only administrated 20mg/d for 1 month.All patients were examined by echocardiography and their plasma BNP concentrations were measured before thrombolysis,24 hour and 1 month,respectively.Results Left ventricular end-diastolic diameter(LVEDd) and concentration of BNP in the high dosage treat group were decreased significantly after 1 month compared with conventional treat group;while left ventricular ejection fraction(LVEF) and left ventricular fractional shortening(LVFS) increased significantly.Conclusion Large dosage of atorvastatin administrated in patients with acute myocardial infarction may improve cardiac function and decrease the level of plasma BNP.更多还原