不同他汀类药物治疗早发冠心病急性心肌梗死患者近期临床随访研究  

Clinical Follow-up Study of Patients with Premature Acute Myocardial Infaction Undergoing Intervention with Different Statins Treatment

作　　者：石蕊[1,2] 姜铁民[2] 赵季红[2] 陈少伯[2] 孙婧[2] 李玉明[2] 

机构地区：[1]天津医科大学研究生院,天津市300070 [2]武警后勤学院附属医院心脏中心,天津市300162

出　　处：《中国全科医学》2012年第23期2619-2622,共4页Chinese General Practice

摘　　要：目的比较不同他汀类药物对早发冠心病急性心肌梗死患者近期的临床疗效,为临床合理使用他汀类药物提供依据。方法选取2009年8月—2010年8月在我院就诊的早发冠心病急性心肌梗死患者74例(其中女性22例,男性52例),年龄男性≤55岁、女性≤65岁。入选患者随机分为两组,A组(n=38)采用瑞舒伐他汀10 mg/d治疗;B组(n=36)采用阿托伐他汀20 mg/d治疗。同期入选经冠状动脉造影检查判定为非冠心病的患者为对照组(n=94例,女39例,男55例)。入选患者均在入选及随机治疗6个月后,于清晨空腹卧位抽取静脉血5 ml,测定空腹血糖、血脂及超敏C-反应蛋白(hs-CRP),检测内皮功能及心脏功能。结果 A、B两组患者治疗前血脂、hs-CRP、左室射血分数(LVEF)及血流介导的内皮舒张功能(FMD)比较,差异均无统计学意义(P>0.05)。治疗6个月后,两组患者的总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及hs-CRP水平间差异有统计学意义(P<0.05)。两组患者治疗6个月时预后良好,无一例死亡,复发心绞痛和血运重建率间差异均无统计学意义(P>0.05)。结论早发冠心病急性心肌梗死患者采用瑞舒伐他汀10 mg/d或阿托伐他汀20 mg/d治疗的近期疗效相近,均可通过降低血脂、减轻炎症反应及改善内皮功能等协助改善早发冠心病急性心肌梗死患者的预后。Objective To study the effects of different statins on blood lipids, inflamatory marker, endothelial func- tion and clinical events in patients with premature acute myocardial infaction. Methods Totally 74 patients （male ≤55 years - old, female≤65 years -old） with premature acute myocardial infaction after successful PCI were randomly divided into two groups to receive rosuvastatin 10 mg/d （n =38, group A） or atorvastatin 10 mg/d （n =36, group B）. Meanwhile, 94 patients were selected as non - CAD group over the same period. Patients were followed up for 6 months and their blood lipids, inflamato- ry marker, endothelium function, and clinical events were measured. Results Compared with the non - CAD group, the ser- um levels of TC, TG, and LDL - C signficantly decreased and HDL - C signficantly increased in both group A and group B （P 〈 0. 05 ） ; meanwhile, the levels of hs - CRP, signifantly decreased and the level of FMD improve （ P 〈 0. 05 ）. The two groups showed no significant difference in terms of the major adverse cardiovascular events （ P 〉0. 05 ）. Conclusion Statin treatment either rosuvastatin or atorvastatin can improve the prognosis of patients with premature acute myocardial infaction by lowering blood lipids, reducing inflammatory response, and improving endothelial function.

关 键 词：冠心病 瑞舒伐他汀 阿托伐他汀 心肌梗死 冠状动脉造影 

分 类 号：R542.22[医药卫生—心血管疾病]