目的 探討瑞舒伐他汀大劑量（20 mg/d）對比常規(guī)劑量（10 mg/d）對中國急性心肌梗死患者經皮冠狀動脈介入（PCI）術后的影響，尋找適合中國人群劑量。方法 計算機檢索PubMed、Cochrane library、中國期刊全文數據庫（CNKI）、中國生物醫(yī)學文獻數據庫（CBM）、維普數據庫（VIP）、萬方數據庫等數據庫關于急性心肌梗死患者PCI術后應用不同劑量瑞舒伐他汀的臨床隨機對照試驗（RCT），檢索時間從建庫至2019年10月，應用Revmen 5.3軟件針對左心室射血分數（LVEF%）、心肌梗死溶栓試驗（TIMI）分級3級、N末端腦鈉肽前體（NT-proBNP）、基質金屬蛋白酶-9（MMP-9）、超敏C-反應蛋白（hs-CRP）、主要不良心血管事件（MACE）發(fā)生率及不良反應發(fā)生率進行Meta-分析。結果 共納入16項RCTs，1 588例患者。Meta-分析結果顯示：與10 mg瑞舒伐他汀相比，20 mg該藥能增加LVEF%（MD=4.30， 95% CI=3.67～7.23），增加TIMI分級3級百分比（OR=5.73，95% CI=3.26～10.08），減少NT-pro BNP水平（MD=-92.83， 95% CI=-120.49～-65.16），減少MMP-9水平（MD=-20.24，95% CI=-25.39～-15.09），減少hs-CRP水平（MD=-1.55， 95% CI=-2.06～-1.04），減少MACE發(fā)生率（OR=0.25，95% CI=0.16～0.39），兩組比較差異均有統(tǒng)計學意義（P<0.01）；兩組間不良反應的差異無統(tǒng)計學意義。結論 對于中國急性心肌梗死行PCI患者，20 mg/d瑞舒伐他汀的臨床療效優(yōu)于標準劑量（10 mg/d），且安全性相當。

Objective To determine the effect and safety of rosuvastatin at high does (20 mg/d) and regular doses (10 mg/d) on acute myocardial infarction with percutaneous coronary intervention (PCI) in Chinese patients in order to explore a safe and effective dose of rosuvastatin for Chinese population. Methods Searched databases such as PubMed, Cochrane Library, CNKI, CMB, VIP and Wanfang Database about randomized controlled trials (RCTs) of different doses of rosuvastatin after PCI in Chinese patients with acute myocardial infarction from inception to October 2019. The Meta-analysis evaluation software Revman 5.3 was applied to analyzed the obtained studies. The changes of left ventricular ejection fraction (LVEF%), thrombolysis in myocardial infarction (TIMI) grade 3, N-terminal brain natriuretic peptide precursor (NT-pro BNP), matrix metallo- proteinase-9 (MMP-9), hypersensitive C-reactive protein (hs-CRP), incidence of major adverse cardiovascular events (MACE) and side effects after different doses of rosuvastatin treatment were compared in different doses. Results A total of 16 RCTs involving 1 588 patients were entered. Metaanalysis showed that high does rosuvastatin significant increase in LVEF% levels (MD=4.30, 95%CI=3.67, 7.23) and TIMI rating by 3 percent (OR=5.73, 95%CI=3.26, 10.08); reduction in NT-pro BNP levels (MD=-92.83, 95%CI=-120.49, -65.16), MMP-9 levels (MD=-20.24, 95%CI=-25.39, -15.09), hs-CRP levels (MD=-1.55,95%CI=-2.06, -1.04) and rate of MACE (OR=0.25, 95%CI=0.16, 0.39) when compared with regular doses rosuvastatin (P<0. 001). There was no significant difference in the incidence of side effects between the two doses. Conclusion For Chinese patients with acute myocardial infarction undergoing PCI, the clinical efficacy of rosuvastatin at 20 mg/d is better than the standard dose (10 mg/d), and the safety is comparable.

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