早期应用他汀类药物对急性心肌梗死病人总胆固醇、高敏C反应蛋白及不良事件的影响

INFLUENCE OF EARLY USE OF STATINS ON THE TOTAL CHOLESTEROL,HYPERSENSITIVITY-C REACTIVE PROTEIN AND ADVERSE EVENT IN PATIENTS ACUTE MYOCARDIAL INFARCTION

目的探讨急性心肌梗死病人早期应用他汀类药物对总胆固醇、高敏C反应蛋白及院内不良事件的影响.方法将78例急性心肌梗死病人根据总胆固醇水平分成2组.治疗组41例,口服洛伐他汀40 mg/d;对照组37例,不用任何降脂药物.测定两组治疗前后总胆固醇和高敏C反蛋白的变化以及院内不良事件的发生率.结果住院24 h两组总胆固醇水平比较,治疗组明显高于对照组,差异有显著性（t=12.28,P〈0.01）.治疗3周后两组总胆固醇水平与住院24 h比较,差异无显著性（t=1.00、0.57,P〉0.05）.住院24 h两组高敏C反应蛋白水平比较差异无显著性（t=0.42,P〉0.05）, 治疗3周后治疗组高敏C反应蛋白水平与对照组比较差异有显著性（t=6.18,P〈0.05）.两组病人院内心脏不良事件的发生率比较差异有显著性（χ^2=4.04～5.49,P〈0.05）.结论急性心肌梗死病人早期应用洛伐他汀对总胆固醇水平无明显影响,但能显著降低高敏C反应蛋白水平,降低院内不良事件发生率.

Objective To study the influence of early use of statins on total cholesterol （TC）, hypersensltivity-C reactive protein （HCRP） and adverse event in patients with acute myocardial infarction （AMI）. Methods According to the levels of TC, 78 cases of AMI were divided into control group （n=37, TC〈5.2 mmol/L） and treatment group （n= 41, TC〈5.2 mmol/L, levastatin 40 mg/d）. The levels of TC and HCRP, before and after treatment, were detected, and untoward event during their hospital stay observed as well. Results TC level was higher in treatment group than the controls for those hospital stay for 24 h, the difference was significant （t= 12.28, P〈0.01） ,but the difference was not significant after three weeks （t= l. 00, 0. 57; P〉0.05）. The level of HCRP between the two groups were not significantly diffcrent during hospital stay for 24 h （t=6.18, P〈0.05）, but great difference appeared after three weeks of treatment （t = 6. 18,P〈0.05）. The difference of incidence of adverse event during hospitalization between the two groups was significant （X^2= 4, 04-5.49, P〈0.05）, Conclusion Early use of levastatin for AMI patients does not influence the level of total cholesterol, but, it can markedly decrease HCRP and the incidence of adverse event.