摘要
目的探讨ST段抬高型急性心肌梗死(STEMI)患者给予强化他汀治疗的临床应用价值及安全性。方法 STEMI患者60例随机分为2组,均接受常规治疗,强化组30例患者加服阿托伐他汀40 mg/d;对照组30例患者加服阿托伐他汀20 mg/d,所有患者在治疗前及治疗4、12周测定血清超敏C反应蛋白(hs-CRP)、血脂和肌酸激酶(CK)水平,观察2组患者治疗前后肝功能、肾功能等的变化,并通过3个月的随访,观察患者主要心脏不良事件发生情况。结果治疗前2组患者血清hs-CRP、血脂、CK水平比较差异无统计学意义(P>0.05)。治疗后强化组hs-CRP降低的幅度优于对照组,且随着治疗时间的延长持续降低(P<0.01)。2组治疗后hs-CRP、TC、TG、LDL-C、CK均较治疗前降低(P<0.01,P<0.05),HDL-C升高(P<0.05);强化组治疗后hs-CRP、TC、LDL-C降低幅度大于对照组(P<0.01,P<0.05)。强化组主要不良心血管事件发生率为10.7%,对照组为21.9%(P<0.05)。2组间肝肾功能指标、CK及相关不良反应比较差异无统计学意义(P>0.05)。结论较大剂量阿托伐他汀干预治疗可持续降低STEMI患者血清hs-CRP浓度及血脂水平,抑制斑块内炎性反应,并具有良好的安全性。
Objective To investigate clinical application and safety of intensive statin therapy for ST segment eleva- tion acute myocardial infarction （STEMI） patients. Methods 60 patients with STEMI were randomly divided into two groups. Treatment group was enrolled 30 patients; they were given atorvastatin 40 mg. The control group was enrolled 30 cases; they were received atorvastatin 20 mg. Meanwhile, patients in these two groups underwent conventional treatment. Serum high sen- sitive C reactive protein （hs-CRP） ,lipid and creatine kinase（CK） levels were recorded in all patients before treatment, after treatment for 4 weeks, and 12 weeks. Liver function, renal function, index changes in these two groups were observed before and after treatment, and through 3 months of follow-up, major adverse cardiac events were recorded. Results Before treat- ment, serum hs-CRP, blood lipid levels and creatine kinase did not show statistical significance between the two groups （ P 〉 0.05）. High sensitivity C- reactive protein in the intensive therapy group were lower than the control group （ P 〈 0.01 ）, and decreased along with prolong of treatment time. After treatment hs-CRP, TC, TG, LDL-C were significantly lower after treatment than before in both of the two groups （ P 〈 0.01, P 〈 0.05 ）, HDL-C increased （ P 〈 0.05 ）, but intensive treatment group decreased more significantly,in hs-CRP,TC and LDL-C than those in cortrol group（ P 〈0.01, P 〈0.05） ;Along with the medication time prolonged, TC and LDL-C in the treatment group. The incidence of major adverse cardiac events was 10.7% in treatment group, and 21.9% in control group（ P 〈0.05 ）. Liver and kidney function index, CK and related adverse reac- tion between the two groups did not show statistical significance （ P 〉 0.05 ）. Conclusion Both the two kinds of doses of atorvastatin can play a lipid-lowering effect, high dose atorvastatin sustainable reduced concentrations of serum hs-CRP in pa- tients with STEMI and serum lipid
出处
《疑难病杂志》
CAS
2012年第8期578-580,共3页
Chinese Journal of Difficult and Complicated Cases
关键词
阿托伐他汀
心肌梗死
ST段抬高型
急性
C反应蛋白
Atorvastatin
Myocardial infarction, ST segment elevation, acute
C reactive protein
