阿托伐他汀在急性心肌梗死患者中使用的安全性

Security of Statin in Treating Patients with Acute Myocardial Infarction

目的观察谷丙转氨酶(alanine transaminase,ALT)升高的急性心肌梗死患者早期使用他汀类药物的安全性。方法从同济医院2003年1月到2011年5月住院的急性心肌梗死患者中筛选出符合入选标准的患者198例,根据入院时ALT的水平和是否接受阿托伐他汀治疗(20mg/d),分为3组。A组:ALT升高并接受阿托伐他汀治疗;B组:ALT升高未接受他汀类药物治疗;C组:ALT正常并接受阿托伐他汀治疗。比较患者治疗1周后ALT的变化。结果治疗1周后,A组与B组比较,ALT>3倍正常值上限(upper limit of normal,ULN)的发生率没有差异(P=0.51);A组和C组比较,ALT>3倍ULN的发生率没有差异(P=0.75)。结论 ALT升高的急性心肌梗死患者早期使用阿托伐他汀不会增加肝脏毒性。

Objective To investigate the safety of 3-hydroxy-3-methylglutaryl coenzyme A reeducates inhibitors（statins）in treating patients,alanine transaminase（ALT）elevated,with acute myocardial infarction（AMI）.Methods We screened patients hospitalized in Tongji Hospital between January 2003 to May 2011 with AMI and selected 198 cases meeting the inclusion criteria.According to ALT levels on admission and whether or not receiving atorvastatin 20 mg/day therapy,all the cases were divided into three groups：group A,ALT elevated and atorvastatin therapy given;group B,ALT elevated and statins not given,and group C,ALT normal and atorvastatin therapy given.Results The incidence of ALT greater than 3 times upper limit of normal（ULN）had no significant difference between group A and group B（P=0.51）,and between group A and group C（P=0.75）.Conclusion Individuals with elevated liver enzymes do not have higher risk for hepatotoxicity from atorvastatin.