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[摘要]
目的 探究急性冠状动脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)后,采用瑞舒伐他汀短期强化治疗对患者心功能、心肌损伤情况及炎症水平的影响。方法 选择2015年1月—2017年12月渭南市中医医院行PCI治疗的ACS患者85例,按照入院先后顺序分为两组,对照组(n=43)行抗凝治疗、抗血小板治疗以及抗血管治疗等,根据患者情况增加血管紧张素转换酶抑制剂或β受体阻滞剂等;观察组(n=42)在上述基础上给予瑞舒伐他汀强化治疗,每天1次,每次剂量为20 mg,须在睡前进行口服,连续治疗1个月。治疗1个月后,观察患者的心功能、心肌损伤及血清炎症因子水平等指标。结果 治疗1个月后,两组治疗后左心室射血分数(LVEF)、房室瓣EA峰比值(E/A)升高,左心室收缩末径(LVSD)、左心室舒张末径(LVDD)降低,但差异均无统计学意义,观察组心功能指标与对照组无显著差异。治疗1个月后,两组患者心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)均显著升高,同组治疗前后比较差异有统计学意义(P<0.05);且观察组cTnI、CK-MB显著低于对照组,组间差异有统计学意义(P<0.05)。治疗1个月后,两组患者脑尿钠肽(BNP)、超敏C反应蛋白(hs-CRP)水平均显著下降,同组治疗前后比较差异有统计学意义(P<0.05);且观察组炎症因子水平明显低于对照组,组间差异有统计学意义(P<0.05)。结论 对行PCI术后的ACS患者采用瑞舒伐他汀短期强化治疗,可有效改善患者心肌损伤情况,降低炎症水平。
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[Abstract]
Objective To explore the short-term intensive treatment of rosuvastatin after percutaneous coronary intervention in patients with acute coronary syndromes, and to evaluate the clinical effects of cardiac function, myocardial injury and serum inflammatory factors.Methods the sample was selected as 85 patients with acute coronary syndrome after percutaneous coronary intervention in our hospital, and the choice of time was controlled from January 2015 to December 2017. The randomized digital table was used for group treatment. The control group (n=43) was selected for routine treatment, and the experimental group (n=42) a short-term intensive treatment regimen was selected on the basis of routine treatment in the control group.Results One month after treatment, LVEF, E/A increased, LVSD and LVDD decreased, but there was no significant difference between the two groups. There was no significant difference in cardiac function between the observation group and the control group. One month after treatment, the levels of cTnI and CK-MB in the two groups were significantly higher than those in the control group (P<0.05), and the levels of cTnI and CK-MB in the observation group were significantly lower than those in the control group (P<0.05). One month after treatment, the levels of BNP and hs-CRP in the two groups were significantly decreased, and there was a significant difference between the two groups before and after treatment (P<0.05); and the levels of inflammatory factors in the observation group were significantly lower than those in the control group, the difference was statistically significant (P<0.05).Conclusion the short-term intensive therapy of rosuvastatin after percutaneous coronary intervention in patients with acute coronary syndromes can effectively improve the level of serum inflammatory factors and myocardial injury, which has no effect on cardiac function, so the drug should be very safe.
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