不同他汀类药物联合双联抗血小板对急性ST段抬高型心肌梗死PCI术后患者脂质代谢指标及心功能的影响

doi:10.3969/j.issn.1671-7171.2026.05.019

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摘要 【目的】探讨不同他汀类药物联合双联抗血小板对急性ST段抬高型心肌梗死经皮冠状动脉介入治疗(PCI)术后患者脂质代谢指标及心功能的影响。【方法】选取2020年4月至2024年8月在本院行PCI的80例急性ST段抬高型心肌梗死患者,采用随机数字表法分为对照组(n=37)和观察组(n=43)。对照组给予阿托伐他汀联合双联抗血小板治疗,观察组给予瑞舒伐他汀联合双联抗血小板治疗。比较两组心功能[左室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)]、实验室指标[心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、氨基末端脑钠肽前体(NT-proBNP)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白E(ApoE)、甘油三酯(TG)、载脂蛋白B(ApoB)、低密度脂蛋白胆固醇(LDL-C)水平以及血小板聚集率(PAR)、心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)],记录两组PCI术后半年内主要心血管不良事件(MACE)、不良反应发生情况。【结果】治疗后,两组LVEF高于治疗前,LVESD、LVEDD短于治疗前,且观察组LVEF高于对照组,LVESD、LVEDD短于对照组,差异有统计学意义(P<0.05)。治疗后,两组cTnI、CK-MB、NT-proBNP、PAR低于治疗前,观察组cTnI、NT-proBNP、PAR低于对照组,差异有统计学意义(P<0.05)。治疗后,两组HDL-C、ApoA1高于治疗前,TG、LDL-C、ApoE、ApoB低于治疗前,且观察组HDL-C、ApoA1高于对照组,TG、LDL-C、ApoE、ApoB低于对照组,差异有统计学意义(P<0.05)。两组PCI术后半年内MACE发生率、不良反应总发生率比较,差异无统计学意义(P>0.05)。【结论】瑞舒伐他汀联合双联抗血小板修复急性ST段抬高型心肌梗死PCI术后受损心肌、改善心功能、调节脂质代谢紊乱的作用优于阿托伐他汀联合双联抗血小板。

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	尚嫄嫄
	吕晓辉

关键词 ： ST段抬高型心肌梗死, 急性病, 羟甲基戊二酰基CoA还原酶抑制剂, 血小板聚集抑制剂, 经皮冠状动脉介入治疗

Abstract：【Objective】 To compare the effects of different statins combined with dual antiplatelet therapy on lipid metabolism indexes and cardiac function in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention (PCI). 【Methods】 A total of 80 patients with acute ST-segment elevation myocardial infarction who underwent PCI in our hospital from April 2020 to August 2024 were enrolled and divided into the control group (n=37) and the observation group (n=43) by random number table method. The control group received atorvastatin combined with dual antiplatelet therapy, while the observation group received rosuvastatin combined with dual antiplatelet therapy. The two groups were compared in cardiac function indicators [Left Ventricular Ejection Fraction (LVEF), Left Ventricular End-Systolic Diameter (LVESD), Left Ventricular End-Diastolic Diameter (LVEDD)] and laboratory indexes [cardiac troponin I (cTnI), creatine kinase isoenzyme (CK-MB), N-terminal pro-brain natriuretic peptide (NT-proBNP), high-density lipoprotein cholesterol (HDL-C), apolipoprotein A1 (ApoA1), apolipoprotein E (ApoE), triglyceride (TG), apolipoprotein B (ApoB), low-density lipoprotein cholesterol (LDL-C), and platelet aggregation rate (PAR)]. The incidence of major adverse cardiovascular events (MACE) and adverse reactions within half a year after PCI were recorded in both groups. 【Results】 After treatment, LVEF increased, LVESD and LVEDD decreased in both groups; the observation group had higher LVEF and lower LVESD, LVEDD than the control group (P<0.05). After treatment, the levels of cTnI, CK-MB, NT-proBNP and PAR in both groups were lower than those before treatment; cTnI, NT-proBNP and PAR in the observation group were lower than those in the control group (P<0.05). After treatment, HDL-C and ApoA1 increased, while TG, LDL-C, ApoE and ApoB decreased in both groups; the observation group had higher HDL-C, ApoA1 and lower TG, LDL-C, ApoE, ApoB than the control group (P<0.05). There were no significant differences in the incidence of MACE and total adverse reaction rate within half a year after PCI between the two groups (P>0.05). 【Conclusion】 Rosuvastatin combined with dual antiplatelet therapy is superior to atorvastatin combined with dual antiplatelet therapy in repairing damaged myocardium, improving cardiac function and regulating lipid metabolism disorder in patients with acute ST-segment elevation myocardial infarction after PCI.

Key words： ST Elevation Myocardial Infarction Acute Disease Hydroxymethylglutaryl-CoA Reductase Inhibitors Platelet Aggregation Inhibitors Percutaneous Coronary Intervention

收稿日期: 2025-08-14

中图分类号:

R542.22

引用本文:

尚嫄嫄, 吕晓辉. 不同他汀类药物联合双联抗血小板对急性ST段抬高型心肌梗死PCI术后患者脂质代谢指标及心功能的影响[J]. 医学临床研究, 2026, 43(5): 773-776.
SHANG Yuanyuan, LUY Xiaohui. Effects of Different Statins Combined with Dual Antiplatelet Therapy on Lipid Metabolism Indexes and Cardiac Function in Patients with Acute ST-Segment Elevation Myocardial Infarction after PCI. JOURNAL OF CLINICAL RESEARCH, 2026, 43(5): 773-776.

链接本文:

http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2026.05.019 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2026/V43/I5/773

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