急性心肌梗塞后他汀类药物治疗对死亡率的影响及与血脂的关系  

Effect of early statin treatment following acute myocardial infarction on mortality and its correlation with lipid level

作　　者：肖骅[1] 周建庆[1] 葛世俊[1] 赵维庆[1] 高丛光[1] 柳俊平[1] 沈文均[1] 周军波[1] 陈文采[1] 

机构地区：[1]宁波市医疗中心李惠利医院,浙江宁波315040

出　　处：《心血管康复医学杂志》2005年第3期231-232,共2页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:研究急性心肌梗塞(AMI)后使用他汀类降脂药物对病人死亡率的影响,及其与血脂水平的关系。方法:对1994年1月至2004年6月期间254例AMI病人(他汀类药物治疗组,简称他汀组156例,未用他汀组98 例)进行随访(平均随访421 d)以确定转归。回顾性分析AMI病人住院时他汀类药物等治疗情况和血脂水平,进行Cox多因素生存分析,研究他汀类药物与AMI死亡率的关系。结果:他汀类药物使用与AMI死亡率独立相关(OR =0.24,95%CI=0.12-0.46,P<0.001)。他汀组死亡23例(14.7%),无他汀组死亡27例(27.6%),两组之间有显著差异(P<0.05),他汀组中高脂血症者与血脂水平正常者死亡率无显著差异(P>0.05)。结论:AMI后使用他汀类药物能减少AMI死亡率,且与血脂水平无关。Objective: To evaluate the association between blood lipid content and statin treatment initiated in hospital following acute myocardial infarction (AMI) and mortality during follow-up. Methods: Participants included 254 patients discharged with a diagnosis of AMI between January 1994 and Jun 2004. The patients were followed up with average 421 days. Multivariable Cox regression analyses were performed to examine the relation between statin treatment and mortality after AMI while controlling for baseline characteristics and early therapeutic interventions. Results :A significant correlation between statin treatment initiated in hospital after AMI and mortality esisted in multi-variable-adjusted regression analyses (OR = 0. 24, 95%CI = 0. 12-0. 46, P<0. 001). Rate of all cause death group was less than that of without statin treatment group during follow-up (P<0. 05). There was no significance difference of mortality between patients with blood lipid high levels and norma level in statin treatment group (P> 0. 05 ). Conclusion: Early initiation of statin treatment in AMI patient is associated with reduced mortality that is not reated to blood lipid level.

关 键 词：死亡率 药物治疗 梗塞后 他汀类药物 他汀类降脂药物 2004年6月 AMI病人 血脂水平 急性心肌梗塞 1994年 回顾性分析 生存分析 治疗情况 药物使用 高脂血症 治疗组 多因素 Cox 住院时 正常者 随访 

分 类 号：R541.405[医药卫生—心血管疾病] R972.6[医药卫生—内科学]