Abstract：【Objective】 To explore effects of large-dose atorvastatin on short term efficacy of emergency PCI and cardiovascular events on patients with stress hyperglycemia (SHG) acute myocardial infarction (AMI).【Methods】Sixty-eight cases of AMI with SHG were randomly divided into observation group and control group, each with 34 cases. All patients received conventional antiplatelet drugs and emergency PCI treatment. In addition, the observation group was given high dose oral atorvastatin (80mg/d, 40mg/d), while the control group was treated with conventional dose (20mg/d).The myocardial perfusion and cardiac function were compared between the two groups, and the incidence of adverse cardiovascular events in 28d was recorded in the two groups.【Results】There was no significant difference in postoperative CK-MB peak, ST segment resolution good (drop≥50%) rate, myocardial perfusion good rate of the two groups in postoperative myocardial perfusion (P>0.05); postoperative 7d LVEF in the observation group was significantly higher than that in the control group (P<0.05); the incidence of heart failure of the observation group 8.82% was significantly lower than that of the control group (29.41%) in 28d follow-up (P<0.05), there was no significant difference in incidence of severe arrhythmia, stenocardia, recurrent myocardial infarction and death in the two groups (P>0.05). 【Conclusion】 Compared with routine dose, large dose atorvastatin has obvious advantages in increasing LVEF 7d after emergency PCI and reducing incidence of 28d heart failure in AMI patients with SHG.
[1] Thalib L,Zubaid M,Rashed W,et al. Impact of diabetic status on the hyperglycemia-induced adverse risk of short term outcomes in hospitalized patients with acute coronary syndromes in the Middle East : findings from the Gulf registry of Acute Coronary Events (Gulf RACE)[J].Clin Med Res,2011,9(1):32-37. [2] 刘军,张承花.GHbA1c在急性心肌梗死合并高血糖患者中的临床价值[J].湖南师范大学学报(医学版),2010,07(2):54-55,62. [3] 诸海军,余猛进,方伟敏,等.血清胰高血糖素和胰岛素在AMI早期对血糖水平的影响[J].医学临床研究,2013,30(10):1968-1970. [4] 戴功强,肖冬梅,丁怀胜,等.应激性高血糖对老年急性心肌梗死患者急诊介入治疗术后支架内再狭窄及临床预后的影响[J].临床内科杂志,2016,33(4):247-249. [5] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会,中国循环杂志编辑委员会.急性心肌梗死诊断和治疗指南[J].中华心血管病杂志,2001,29(12) : 710-725. [6] 丁超,李俊峡,赵玉英,等.他汀类药物对急性心肌梗死患者经皮冠状动脉介入治疗术后再灌注心律失常的影响[J].临床误诊误治,2011,24(1 ):11-12. [7] 戴敬,孟康,吕树铮,等.他汀类药物对急性心肌梗死患者应激性高血糖的影响[J].中国循证心血管医学杂志,2014,6(2):160-161,165. [8] 陈来特,张怀勤,林以诺,等.阿托伐他汀对急性心肌梗死致应激性高血糖的干预作用[J].实用医学杂志,2012,28(5):718-720. [9] 赵菁,马旃,赵兴山,等.强化他汀类药物对伴有应激性高血糖的急性心肌梗死患者急诊介入治疗预后的影响[J].山东医药,2011,51(44):73-75.
2017, Vol. 34 
