不同剂量阿托伐他汀对急性心肌梗死患者血浆致动脉硬化指数及预后的影响  

Influences of Atorvastatin in different doses on atherogenic index of plasma and outcomes in patients with acute myocardial infarction

作　　者：宝凤梅 马伟利 张莉莉 

机构地区：[1]朝阳市中心医院心内科,辽宁省朝阳市122000

出　　处：《中国心血管病研究》2017年第10期945-949,共5页Chinese Journal of Cardiovascular Research

摘　　要：目的探讨不同剂量阿托伐他汀对急性心肌梗死（AMI）患者血浆致动脉硬化指数（AIP）及主要不良心血管事件（MACE）的影响。方法选取2015年1月至2016年1月于我院心内科住院主要诊断为AMI并完成随访的患者212例，随机分为标准治疗组（106例）和强化治疗组（106例）。所有患者均予以AMI的常规治疗。标准治疗组患者同时予以阿托伐他汀20mg／d口服，强化治疗组同时予以阿托伐他汀40mg／d口服。随访1年。比较两组患者治疗前后血脂、AIP、脉搏波传导速度（PWV）等指标的变化及MACE的发生。结果AMI患者AIP与PWv呈显著正相关（r=0．801，P〈0．05）。与治疗前比较，两组患者AIP指标均降低（0．22±0．05比0．34±0．06，0．17±0．05比0．33±0．06），强化治疗组患者颈动脉内中膜厚度减少[（1．41±0．18）mm比（1．10±0．17）mm]，差异有统计学意义（P〈0．05）。与标准治疗组比较，强化治疗组AIP指标变化更为显著（0．22±0．05比0．17±0．05），差异有统计学意义（P〈0．05）。两组不良反应发生率比较，差异无统计学意义（P〉0．05）。治疗1年后两组患者总的MACE发生比较（22．64％比11．32％），差异有统计学意义（P〈0．05）。结论阿托伐他汀强化治疗AMI，不仅可进一步降低患者血脂水平，还有更好的抗动脉硬化作用，能降低AMI后MACE的发生，值得临床推广应用。Objective To investigate the influences of Atorvastatin on atherogenic index of plasma and （AIP） and major adverse cardiovascular events （MACE） in patients with acute myocardial infarction （AMI）. Methods A total of 212 patients diagnosed as AMI in our department were randomly divided into two groups： the standard group （n=106） and the intensive group （n=106）. Both group patients were given basic treatment of AMI. Patients in the standard group were given Atorvastatin （20 mg/d ） and patients in the intensive group were given Atorvastatin（40 mg/d）. Blood lipid, AIP and pulse wave velocity（PWV） were evaluated after 1 years＇ therapy. At the same time, the incidence of MACE were recorded. Results Relation analysis showed that AIP level was positively correlated with PWV （r=0.801, P〈0.05）. After 1 years＇ treatment, the AIP were decreased in both group patients[before treatment （0.34±0.06） vs after treatment （0.22±0.05）, P〈0.05 ] and [before treatment（0.33±0.06） vs after treatment（0.17±0.05 ）, P〈0.05 ], and the changes were more marked in intensive group [at standard group （0.22±0.05） vs at intensive group （0.17±0.05）, P〈0.05]. The intima-media thickness in the intensive treatment group was significantly lower than that before treatment [ before treatment （ 1.41 ±0.18 ）mm vs after treatment （ 1.10 ± 0.17）ram, P〈0.05]. After 1 years＇ treatment, the incidence of MACE was lower in intensive group than that in standard group （at standard group 22.64% vs at intensive group 11.32%, P〈0.05） Conclusion The intensive treatment of Atorvastatin can significantly reduced AIP levels and MACE in the patients with AMI.

关 键 词：急性心肌梗死 动脉硬化 血浆致动脉硬化指数 脉搏波传导速度 主要不良心血 管事件 

分 类 号：R542.22[医药卫生—心血管疾病]