摘要
目的观察早期应用不同剂量阿托伐他汀治疗急性ST段抬高型心肌梗死的临床疗效。方法选取我院2012年1月~2015年6月期间收治的135例确诊为急性ST段抬高型心肌梗死患者,采用随机数字法将其分为3组,所有患者入院后均给予再灌注、抗血小板、抗凝、抗心肌缺血等治疗,并加以服用阿托伐他汀,小剂量组入院起长期服用20 mg/d,常规剂量组入院起第1月服用40 mg/d,后长期服用20 mg/d,大剂量组入院起第1月服用80 mg/d,后长期服用20 mg/d,并观察治疗效果和1年内心血管事件的发生几率及不良反应。结果大剂量组和常规剂量组总有效率分别为93.33%、84.44%高于小剂量组的66.67%（P〈0.05）,但大剂量组和常规剂量组间差异无统计学意义（P〉0.05）;随访1年内常规组和大剂量组心血管事件发生率分别为8.89%、15.56%明显低于小剂量组（P〈0.05）,大剂量组和常规剂量组心血管事件发生率差异无统计学意义（P〉0.05）,大剂量组出现肝功能异常（转氨酶〉3×ULN）3例,无出现严重肌肉不良事件（肌痛、肌无力及CK〉5×ULN）,常规剂量组及小剂量组均未出现肝功能异常及严重肌肉不良事件。结论常规剂量和大剂量阿托伐他汀治疗急性ST段抬高型心肌梗死近期疗效显著,明显降低1年内心血管事件发生率,常规剂量组肝安全性更高。
Objective To observed the clinical effect of early application of different doses of atorvastatin in the treatment of acute ST segment elevation myocardial infarction. Methods Select 135 patients with acute ST segment elevation myocardial infarction of our hospital from January 2012 to June 2015, randomly divided into 3 groups. All patients were treated with 20 mg/d, anti platelet, anticoagulation, anti myocardial ischemia, and then received 40 mg/d for a long time. After received 80 mg/d for a long time, first months after taking, the long-term administration of 20 mg/d, observe the therapeutic effect and the incidence of vascular events in the 1 years, the probability of occurrence and adverse reactions. Results The total effective rate was 93.33% and 84.44% in the large dose group and the conventional dose group was significantly higher than 66.67% in the low dose group, However, there was no significant difference between large dose group and conventional dose group（P〉0.05）; Follow up for 1 years, The incidence of cardiovascular events in the conventional group and high-dose group was 8.89% and 15.56% was significantly lower than that in the low dose group（P〈0.05）, but no significant difference in the incidence of cardiovascular events in the high-dose group and the conventional dose group（P〉0.05）, The large dose group and conventional dose group of cardiovascular events was no significant difference（P〈0.05）, large dose group showed abnormal liver function（ALT 〉3 × ULN） in 3 cases, no serious adverse events（myalgia, muscle weakness and CK〉 5 × ULN）, abnormal liver function and severe muscle adverse events there were no conventional dose group and small dose group. Conclusion Conventional dose and high dose atorvastatin in the treatment of acute ST segment elevation myocardial infarction in the near future curative effect is significant, significantly reduce the incidence of vascular events in 1 years, the conventional dose group liver safety is higher.
出处
《中国卫生标准管理》
2015年第33期113-115,共3页
China Health Standard Management
关键词
急性ST段抬高型心肌梗死
阿托伐他汀
不同剂量
疗效
复发
Acute ST segment elevation myocardial infarction
Atorvastatin
Different dosage
Curative effect
Recurrence
