阿托伐他汀对急性心肌梗死患者择期PCI术后胎盘生长因子水平及心肌灌注的影响

目的:探讨阿托伐他汀对急性心肌梗死患者择期经皮冠状动脉介入治疗(PCI)术后血清胎盘生长因子水平及心肌灌注的影响。方法:选择行择期PCI治疗的急性心肌梗死患者120例,随机分为阿托伐他汀组(60例)和对照组(60例)。阿托伐他汀组于PCI术前1周开始给予阿托伐他汀20mg,每晚1次。分别测定2组患者术前、术后1d、术后2周血清胎盘生长因子水平,观察2组PCI术后15min校正的TIMI帧数计数,同时行冠状动脉血流速度测定。术后2周行心肌核素显像分析,计算心肌灌注显像积分。结果:阿托伐他汀组术前、术后1d血清胎盘生长因子水平显著低于对照组(9.13±2.56)ng/L∶(13.14±4.03)ng/L,(9.75±2.37)ng/L∶(14.53±3.41)ng/L,P<0.01],术后2周2组血清胎盘生长因子水平比较差异无统计学意义(9.86±2.14)ng/L∶(10.02±2.01)ng/L,P>0.05)]。阿托伐他汀组校正的TIMI帧数计数明显低于对照组(26.28±5.71)帧∶(35.12±6.18)帧,P<0.01],冠状动脉血流速度高于对照组(151.23±36.7)mm/s∶(130.82±40.2)mm/s,P<0.05],阿托伐他汀组术后2周心肌灌注显像积分低于对照组(2.0±0.5)∶(3.5±0.6),P<0.05]。结论:急性心肌梗死患者择期PCI术前给予阿托伐他汀治疗可能通过抗炎作用改善心肌灌注水平。

Effects of atorvastatin on serum placental growth factor level and improving myocardium reperfusion in patients with acute myocardial infarction after delayed percutaneous coronary intervention

Objective:To explore the effects of atorvastatin on serum placental growth factor(PlGF) level and myocardium reperfusion in patients with acute myocardial infarction(AMI) after delayed percutaneous coronary intervention(PCI). Method:One hundred and twenty patients with AMI were randomly divided into two groups,atorvastatin-treated group(60 cases) and routine-treated group(60 cases).The patients in the two groups were all received the coronary secondary prevention,the atorvastatin-treated group added atorvastatin(20 mg,one time per day) forseven days before PCI.Serum PlGF was measured before PCI and at one day,two weeks after PCI in both groups.The corrected TIMI frame count(CTFC),coronary blood velocity were observed at 15 minutes after PCI.Analysis of myocardial perfusion tomography in two patients was performed at two weeks after PCI. Result:The peak of serum PlGF level before and one dayafter PCI in atorvastatin-treated group was significantly lower than those patients in the control group(9.13±2.56]ng/L∶13.14±4.03]ng/L,9.75±2.37]ng/L∶14.53±3.41]ng/L,P<0.01),but there wasno significant difference between the groups in serum PlGF level at two weeks after PCI(9.86±2.14]ng/L∶10.02±2.01]ng/L,P>0.05).The CTFC in atorvastatin-treated group was significantly lower than thatin control group(26.28±5.71]∶35.12±6.18]),but coronary blood velocity in atorvastatin-treated group wassignificantly higher than thatin the control group(151.23±36.7]mm/s∶130.82±40.2]mm/s).In atorvastatin-treated group,points of myocardial perfusion imaging(2.0±0.5) were significantly lower than those in the routine-treated group(3.5±0.6). Conclusion:Administration of atorvastatin before delayed PCI may significantly improve myocardial microvascular perfusion through anti-inflammation effect.