OBJECTIVE:To explore loading dose simvastatin on related indicators in PCI perioperative period of patients with acute myocardial infarction. METHODS:Data of 203 acute myocardial infarction patients undergoing emergency PCI were retro-spectively collected and divided into observation group (102 cases) and control group (101 cases) by different regimens. Control group received conventional treatment for 3 d before PCI,including orally taking Aspirin enteric-coated tablet 300 mg/d,qd + Sim-vastatin tablet 40 mg/d,qd,simvastatin 40 mg/d after surgery,qd,for 4 weeks. Observation group received Simvastatin tablet 80mg 2 h before PCI,the other treatment was the same with control group. Total cholesterol(TC),triglyceride(TG),low-density li-poprotein cholesterol (LDL-C),high-density lipoprotein cholesterol(HDL-C),IL-6,IL-10,TFN-α,plasma super-sensitive tropo-nin(TNT-HSST)level,creatine kinase isoenzyme(CKMB)level,high sensitive C-reactive protein(hs-CRP)level and transami-nase level before and 24 h after treatment were observed and the incidence of adverse reactions was recorded. Meanwhile,the inci-dence of postoperative 30 d of MACE and CIN was followed-up. RESULTS:There was no significant difference in TG,TC, LDL-C,HDL-C before and after treatment(P>0.05). Before treatment,there was no significant difference in TNF-α,IL-6,IL-10, hs-CRP,CKMB,TNT-HSST levels in 2 groups (P>0.05);after treatment,TNF-α,IL-6,hs-CRP,CKMB,TNT-HSST levels were significantly higher than before(P0.05).治疗前,两组患者TNF-α、IL-6、IL-10、hs-CRP、CKMB、TNT-HSST水平比较,差异无统计学意义(P>0.05).治疗后,两组患者TNF-α、IL-6、hs-CRP、CKMB、TNT-HSST水平显著高于同组治疗前,且观察组TNF-α、IL-6、hs-CRP水平显著低于对照组,CKMB、TNT-HSST水平显著高于对照组;两组患者IL-10水平显著低于同组治疗前,但观察组显著高于对照组,差异均有统计学意义(P<0.05).观察组患者MACE和CIN发生率显著低于对照组,差异均有统计学意义(P<0.05).治疗期间两组患者均未见明显不良反应发生.结论:急性心肌梗死患者PCI围术期使用负荷剂量辛伐他汀不仅能显著降低患者TNF-α、IL-6和hs-CRP水平,升高CKMB、TNT-HSST和IL-10水平,还能降低术后MACE及CIN的发生率.
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