目的 探討瑞舒伐他汀大劑量（20 mg/d）對(duì)比常規(guī)劑量（10 mg/d）對(duì)中國(guó)急性心肌梗死患者經(jīng)皮冠狀動(dòng)脈介入（PCI）術(shù)后的影響，尋找適合中國(guó)人群劑量。方法 計(jì)算機(jī)檢索PubMed、Cochrane library、中國(guó)期刊全文數(shù)據(jù)庫（CNKI）、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫（CBM）、維普數(shù)據(jù)庫（VIP）、萬方數(shù)據(jù)庫等數(shù)據(jù)庫關(guān)于急性心肌梗死患者PCI術(shù)后應(yīng)用不同劑量瑞舒伐他汀的臨床隨機(jī)對(duì)照試驗(yàn)（RCT），檢索時(shí)間從建庫至2019年10月，應(yīng)用Revmen 5.3軟件針對(duì)左心室射血分?jǐn)?shù)（LVEF%）、心肌梗死溶栓試驗(yàn)（TIMI）分級(jí)3級(jí)、N末端腦鈉肽前體（NT-proBNP）、基質(zhì)金屬蛋白酶-9（MMP-9）、超敏C-反應(yīng)蛋白（hs-CRP）、主要不良心血管事件（MACE）發(fā)生率及不良反應(yīng)發(fā)生率進(jìn)行Meta-分析。結(jié)果 共納入16項(xiàng)RCTs，1 588例患者。Meta-分析結(jié)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(jí)3級(jí)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M(fèi)MP-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M(fèi)ACE發(fā)生率（OR=0.25，95% CI=0.16～0.39），兩組比較差異均有統(tǒng)計(jì)學(xué)意義（P<0.01）；兩組間不良反應(yīng)的差異無統(tǒng)計(jì)學(xué)意義。結(jié)論 對(duì)于中國(guó)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(biāo)準(zhǔn)劑量（10 mg/d），且安全性相當(dāng)。

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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