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大剂量瑞舒伐他汀对 ST 段抬高型心肌梗死患者心室重构及心功能的影响。

Effects of High-Dose Rosuvastatin on Ventricular Remodelling and Cardiac Function in ST-Segment Elevation Myocardial Infarction.

机构信息

Department of Cardiology, Qingpu Medical Center, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.

出版信息

Drug Des Devel Ther. 2020 Sep 23;14:3891-3898. doi: 10.2147/DDDT.S254948. eCollection 2020.

Abstract

OBJECTIVE

To investigate the effects of high-dose rosuvastatin on ventricular remodelling and cardiac function in ST-segment elevation myocardial infarction (STEMI).

MATERIALS AND METHODS

From January 2017 to March 2019, the clinical data of 93 patients with STEMI were collected and analysed, with 46 cases in the conventional-dose group (rosuvastatin, 10 mg/d) and 47 cases in the high-dose group (rosuvastatin, 20 mg/d). Blood lipid (TC, TG, LDL-C and HDL-C), serum inflammatory markers (hs-CRP, IL-6, TNF-α and ICAM-1), ventricular remodelling markers (NT-pro BNP, MMP-9, TIMP-4 and Gal-3) and indicators of cardiac function (LVESD, LVESD, LVESV, LVEDV, IVST and LVEF) were collected from all patients at the time of admission and 8 weeks after rosuvastatin treatment.

RESULTS

After treatment with rosuvastatin for 8 weeks, compared with those in conventional-dose group, the levels of TC, TG, LDL-C, hs-CRP, IL-6, TNF-α, ICAM-1, NT-pro BNP, MMP-9 and Gal-3 in the high-dose group decreased significantly (P<0.05), while the increase of HDL-C and TIMP-4 levels was more obvious (P<0.05) than that in the conventional-dose group. Moreover, LVEF was significantly higher (P<0.05) and LVESD, LVESD, LVESV, LVEDV and IVST were significantly lower (P< 0.05) after treatment than before treatment in both groups. The improvement of cardiac ultrasound results in the high-dose group was more significant than that in the conventional-dose group (P< 0.05).

CONCLUSION

This study suggests that high-dose rosuvastatin was better than conventional-dose rosuvastatin for improving blood lipid metabolism, reducing the inflammatory response, and preventing and treating ventricular remodelling and myocardial fibrosis, indicating that high-dose rosuvastatin had stronger therapeutic effect on STEMI than conventional-dose rosuvastatin.

摘要

目的

研究大剂量瑞舒伐他汀对 ST 段抬高型心肌梗死(STEMI)患者心室重构和心功能的影响。

材料与方法

回顾性分析 2017 年 1 月至 2019 年 3 月期间收治的 93 例 STEMI 患者的临床资料,根据瑞舒伐他汀的剂量分为常规剂量组(10mg/d)和大剂量组(20mg/d),每组 46 例。比较两组患者的血脂(TC、TG、LDL-C、HDL-C)、血清炎症标志物(hs-CRP、IL-6、TNF-α、ICAM-1)、心室重构标志物(NT-proBNP、MMP-9、TIMP-4、Gal-3)和心功能指标(LVESD、LVEDD、LVESV、LVEDV、IVST、LVEF)。

结果

治疗 8 周后,与常规剂量组比较,大剂量组患者的 TC、TG、LDL-C、hs-CRP、IL-6、TNF-α、ICAM-1、NT-proBNP、MMP-9、Gal-3 水平显著降低(P<0.05),HDL-C、TIMP-4 水平显著升高(P<0.05);两组患者的 LVEF 均显著升高(P<0.05),LVESD、LVEDD、LVESV、LVEDV、IVST 均显著降低(P<0.05);大剂量组患者的上述超声心动图指标改善情况均显著优于常规剂量组(P<0.05)。

结论

与常规剂量相比,大剂量瑞舒伐他汀可更好地改善血脂代谢,减轻炎症反应,预防和治疗心室重构及心肌纤维化,提示大剂量瑞舒伐他汀对 STEMI 的治疗效果优于常规剂量。

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