| Objective: Coronary atherosclerosis is the main pathology of coronary heartdisease, The rupture of atherosclerosis plaque and inflammatory response caused theformation of blood clots,Thrombosis blocked coronary arteries, causing ST elevationmyocardial infarction. At present the main way to open coronary blood vesselsincluding: percutaneous coronary intervention and thrombolytic therapy, Thrombolytictherapy is the leading treatment strategies to STEMI in grass-roots hospitals. Urokinaseis a non-specific plasminogen activator, which is the most commonly used mediniceto the treatment of STEMI in grass-roots hospitals currently. Atorvastatin has lipidlowering properties and also provides cardiovascular protection beyond those directlyattributable to the lipid lowering effect,Which is widely used in treatment of coronaryartery disease, Recent studies indicate that patients with STEMI should be given statinsimmediately after admission whether the lipid level is high or low. After high-doseatorvastatin in patients with STEMI can play a better role in cardiovascular protectionand significantly improve clinical outcomes.The objective of the study is to discuss theinfluence of initial loading dose of atorvastatin on recanalization of thrombolytictherapy、inflammatory cytokines and major adverse cardiovascular events in acutemyocardial infarction patients,then explore the benefits and safety of atorvastatinbefore thrombolysis.Methods:82patients with STEMI from2010June–2011June in our hospitalreceived emergency thrombolytic therapy were randomly divided into experimentalgroup and control group. The experimental group were given80mg of atorvastatinbefore thrombolytic therapy,and the control group were given20mg at the sametime,then the two groupes were all given1500000u of urokinase driping within30minutes and conventional treatment drugs. Observe the effect of thrombolysis treatment、the changes of hs-CRP before and after treatment,and follow-up of the levelof incidence of cardiovascular events in1month.Results:1Compared with the control group, the time of Chest pain relief were notdifferent (1.3±0.2h vs1.4±0.3h, P>0.05), ST segment fell were not different（1.0±0.4mv vs0.9±0.3mv,P>0.05），the peak of enzyme appear ahead of time（12.4±1.3h vs13.3±1.7h, P<0.05）, the reperfusion arrhythmias ahead oftime(1.3±0.2h vs1.5±0.2h,P<0.05), the rate of successful recanalization increased（72%vs63%, P<0.05）in the experimental group.2Compared with the control group, the value of hscrp was no difference beforetaking the medicine（3.10±0.36mg/L vs3.17±0.40mg/L,P>0.05）, one week later,thevalue of hscrp reduced significantly（2.32±0.28mg/L vs3.88±0.29mg/L,P<0.05），twoweek later, the value of hscrp reduced much more significant（2.02±0.32mg/L vs2.97±0.28mg/L,P<0.05）.3One month of follow-up, compared with the control group,the incidence ofpostinfarction angina (7.7%vs9.3%); the incidence of heart failure (12.8%vs14%); theincidence of again recurrent myocardial infarction incidence (5.1%vs7.0%);theincidence of arrhythmia (15.4%vs14%); the incidence of cardiac death incidence(5.1%vs6.9%), All were not significantly different (p>0.05).Conclusion:1The initial loading dose (80mg) of atorvastatin can improve thrombolyticrecanalization rates, reduce coronary artery opening time, suggesting that the initialloading dose (80mg) of atorvastatin before thrombolysis can significantly improve thethrombolytic efficacy;2The initial loading dose (80mg) of atorvastatin can significantly reduce thelevels of hsCRP, suggesting that it can reduce the inflammation reaction in the body.3One month of follow-up, cardiovascular events showed no decline, suggestingthat the initial loading dose (80mg) of atorvastatin before thrombolysis is no significantbenefit to one month of cardiovascular events for patients with STEMI. |
PDF Full Text Request