大剂量阿托伐他汀在急性心肌梗死患者急诊冠状动脉介入治疗围手术期的应用研究心血管学专业论文.docx

The application research of high-dose atorvastatin to acute myocardial infarction patients during percutaneous coronary artery interventional therapy A randomized controlled clinical research about Chinese people Abstract Objective To assess high-dose atorvastatin used in patients with acute st-elevation myocardial infarction(STEMI)with primary percutaneous coronary intervention(PPCI) with close, long-term prognosis and the impact of adverse reactions, to optimize the patients with acute st-elevation myocardial infarction perioperative regimen. Method Consecutive selected a total of 120 cases with STEMI in our hospital from June 2010 to November 2012.All selected cases received PPCI therapy.120 selected cases were divied to two groups by random principle:atorvastatin 20mg/d group (20mg atorvastatin was given before PPCI,20mg/d after the PCI,n=60) or 40mg/d group ( given 80mg atorvastatin before PPCI in emergency,40mg/d after PCI,then,20mg/d the first month after PCI,n=60) .After the operation each group was compared thrombolysis in myocardial infarction(TIMI) flow grade,TIMI myocardial perfusion(TMP) grade, corrected TIMI frame (CTFC),70% ST segment drop after two hours.Quantitative indicators of myocardial infarction，Indices of blood biochemistry, N-terminal pro-brain atriuretic peptide(NT-proBNP), Compared Creatine kinase isoenzyme (CK-MB),troponin I (cTnI),high sensitivity C-reactive protein(hs-CRP) peak and the peak time, the change of plasma cholesterol,the influence of Liver and kidney function, recurrence of myocardial infarction and death during hospitalization et al.Follow-up of patients,record the rate of major adverse cardiovascular events (MACE),the result of cardiac ultrasonography and the level of plasma cholesterol,N-terminal pro-brain atriuretic peptide(NT-proBNP), Liver and kidney function,creatine kinase(CK).Carrie on the statistical analysis of relevant data. Result 1.Compared with the 20mg group,the 40mg group blood perfusion of TIMI 3