摘要
目的评价不同他汀类药物治疗急性心肌梗死(AMI)的临床效果及随访结果。方法回顾性分析该院168例AMI患者的临床资料,收集在AMI常规治疗下,分别用阿托伐他汀、辛伐他汀和瑞舒伐他汀治疗6个月患者的血脂、血糖、炎性因子和心血管相关功能项目指标改变情况,以及随访6个月药物不良反应和不良心血管事件的发生情况并比较。结果经治疗后,三种他汀类药物较治疗前能显著降低患者的总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)和超敏C反应蛋白(hs-CRP)水平,升高高密度脂蛋白胆固醇(HDL-C)的浓度(P<0.05);瑞舒伐他汀治疗后患者的hs-CRP降低程度和HDL-C升高程度较其他两种药物相比差异具有统计学意义(P<0.05);阿托伐他汀、瑞舒伐他汀治疗可使得患者空腹血糖(FPG)浓度显著升高(P<0.05),瑞舒伐他汀治疗后患者FPG、糖化血红蛋白(Hb A1c)升高程度较其他两组相比差异有统计学意义(P<0.05);三种他汀类药物均可显著改善患者的肱动脉内皮依赖性舒张功能(FMD)(P<0.05),各组间相比差异无统计学意义(P>0.05);阿托伐他汀、辛伐他汀和瑞舒伐他汀不良药物反应率分别为4.23%、5.77%和4.44%,不良心血管事件发生率分别为5.63%、9.62%和6.67%,各组间相比差异无统计学意义(P>0.05)。结论不同他汀药物在AMI治疗中有良好的临床效果和安全性,阿托伐他汀、辛伐他汀和瑞舒伐他汀在具体的调脂、抗炎作用和改善外周血管舒张功能作用上大致相似也略有不同,对患者血糖产生的影响也有所差异,应注意个体化用药。
Objective To study the clinical effects of different statins on acute myocardial infarction（AMI） and the follow-up resuhs. Methods The data of 168 cases with AMI within 2 years were retrospectively analyzed. All the patients received the conventional therapy for AMI. The levels of blood lipid, blood sugar and inflammation fac- tors, and the changes of the cardiovascular function were detected and compared among different groups of the patients who received different statins of atorvastatin, simvastatin and rosuvastatin 6 months after the treatment. The inci- dences of adverse drug reactions and adverse cardiovascular events were compared among different groups after a fol- low-up of six months. Results The levels of TC, TG, LDL-C and hs-CRP were decreased significantly meanwhile the level of HDL-C was increased significantly in the patients who received the different statins before the treatment （P 〈 O. 05） ; There were significantly differences among rosuvastatin, atorvastatin and simvastatin in the effects of decrea- sing hs-CRP level and increasing HDL-C level （P 〈 0. 05 ） ; Atorvastatin and rosuvastatin could significantly increase the concentration of FPG in the patients （ P 〈 0.05 ）. There was a significant difference in the effects of increasing FPG and HbA1 c between rosuvastatin groups compared with those in the other two groups. Three kinds of statins could significantly improve FMD （ P 〈 0. 05 ）, however there was no significant differences among them （ P 〉 0.05 ）. There was no significant difference in the rate of adverse reactions between atorvastatin（4. 23% ）, simvastatin（5. 77% ） and rosuvastatin （4. 44% ）. There was no significant difference in the incidence of adverse cardiovascular events betweenatorvastatin （ 5.63% ）, simvastatin （ 9. 62% ） and rosuvastatin （ 6. 67 % ） （ P 〉 0.05 ）. Conclusion Atorvastatin, simvastatin and rosuvastatin have similar clinical efficacy and safety in the treatment of AM! and they should be used individ
出处
《中国临床新医学》
2017年第5期450-455,共6页
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
