强化降脂治疗改善急性心肌梗死患者预后的临床研究

Aggressive Lipid Lowering Treatment on Prognosis of Acute Myocardial Infarction: A Clinic Randomized Trial

目的探讨急性心肌梗死后强化降脂方案对患者临床预后的作用。方法急性心肌梗死溶栓临床再通的患者102例,随机分为2组,对照组给予辛伐他汀20mg,治疗组给予辛伐他汀80mg,随访1年,观察患者心血管事件的发生情况。结果强化降脂治疗组LDL-C水平从124.96±7.98mg/dL降至86.14±3.47mg/dL,与对照组从124.18±8.24mg/dL降至103.62±3.68mg/dL相比,降低有统计学意义,P<0.05;强化降脂组的心源性死亡率有减少的趋势(治疗组2例:对照组5例),但未达到统计学意义;强化降脂组的总心血管事件发生率低于对照组,治疗组10例:对照组19例,P<0.05;(4)两组比较,肌溶解、肝功能损害等不良事件的发生率无统计学意义。结论辛伐他汀80mg的强化降脂方案安全有效,可以改善急性心肌梗死患者的预后。

Objective To investigate the roll of aggressive lipid lowering treatment on prognosis of patients with acute myocardial infarction （AMI）. Methods 102 AMI patients, being re-perfusion after fibrinolytic therapy, were assigned to receive a moderate lipid-lowering regimen consisting of 20 mg of simvastatin or an intensive lipid-lowering regimen consisting of 80 mg of simvastatin. The outcomes were cardiovascular events one year after AMI. Results low-density lipoprotein cholesterol level was reduced from 124. 96±7.98 mg/dL to 86.14±3.47 mg/dL in the aggressive lipid lowering treatment group, and from 124. 18±8.24 mg/dL to 103.62±3.68 mg/dL in the control group （P〈0.05）. The cardiac death occurred in 2 treatment patients and in 5 control patients （P〉0.05）. The total cardiovascular events were reduced in treat group, 10 cases vs 19 cases （P〈0.05）. No significant difference was found in safety events （P〉0.05）. Conclusion The aggressive lipid lowering treatment with 80 mg of simvastatin is safe and effective to improve the prognosis of AMI patients.