摘要
目的:观察并探讨强化瑞舒伐他汀治疗急性ST段抬高型心肌梗死(STEMI),患者8-羟基脱氧鸟苷(8-OHdG)和内皮细胞特异性分子1(ESM-1)的水平变化及预后。方法:入选行直接PCI的急性STEMI患者116例,随机分为强化他汀组(瑞舒伐他汀术前20mg,术后20mg/d)和常规他汀组(瑞舒伐他汀术前10mg,术后10mg/d)。观察两组患者入院即刻和术后24h、第4天、第7天8-OHdG和ESM-1的水平变化。随访比较两组患者术后30d内主要不良心脏事件(MACE)和不良反应的差异。结果:两组患者8-OHdG和ESM-1水平在术后24h均明显上升,在术后第4天、第7天均呈下降趋势,强化他汀组较常规他汀组下降更明显(P<0.05);入院即刻8-OHdG水平与ESM-1水平呈正相关(r=0.562,P<0.05)。强化他汀组肌酸激酶同工酶(CK-MB)和心肌肌钙蛋白I(cTnI)峰值水平均低于常规他汀组(P<0.05)。两组患者在MACE事件以及不良反应上比较均差异无统计学意义。结论:强化瑞舒伐他汀在STEMI患者治疗中能够更加迅速降低氧化应激反应并改善血管内皮功能,从而保护心肌、稳定动脉粥样硬化斑块。
Objective：To observe the changes of serum 8-hydroxy-2＇-deoxyguanosine（8-OHdG）and endothelialcell-specific molecule-1（ESM-1）levels and prognosis of intensive rosuvastatin in treatment of patients with acute ST-segment elevation myocardial infarction（STEMI）.Method：A total of 116 acute STEMI patients received primary PCI were enrolledand and randomized into 2 groups：patients in intensive group were treated by rosuvastatin20 mg before PCI and 20 mg/d after PCI,patients in routine group received rosuvastatin 10 mg before and 10 mg/d after PCI.The levels of 8-OHdG and ESM-1 in two groups were observed immediately after admission as well as 24 h,4 dand 7 dafter PCI.The major adverse cardiac events（MACE）and adverse reactions were compared between two groups within 30 days after PCI.Result：Levels of 8-OHdG and ESM-1 of two groups were significantly increased at 24 hafter PCI,while were decreased at 4 th and 7 th day,the decrease in intensive group was more obvious than that in routine group（P0.05）;the 8-OHdG level was positively correlated with the ESM-1 level at the time of admission（r=0.562,P0.05）.The peak level of CK-MB and cTnI in intensive group were lower than those in routine group（P0.05）.Conclusion：Intensive rosuvastatin improves the oxidative stress response and endothelial function in patients with STEMI,thereby protecting the myocardium and stabilizing atherosclerotic plaques.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2018年第2期127-131,共5页
Journal of Clinical Cardiology
基金
广州市医药卫生科技项目(No:20171A011314)
