阿托伐他汀序贯疗法在急性心肌梗死患者中的应用

Application of atorvastatin sequential therapy in patients with acute myocardial infarction

目的探讨阿托伐他汀序贯疗法在急性心肌梗死(AMI)患者中的应用效果。方法按照随机对照原则将132例AMI患者分为观察组和对照组各66例,观察组患者给予阿托伐他汀序贯疗法,对照组患者给予口服阿托伐他汀20 ng/d治疗。观察两组患者入院后24 h、4周、8周的早晨空腹血脂变化,包括甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、肌酸激酶(CK)。结果观察组患者治疗4周后的血TC、TG、LDL-C水平分别为(4.09±0.68)、(1.52±0.39)、(2.68±0.90)mmol/L,均低于对照组患者的(4.81±0.97)、(1.62±0.47)、(2.93±0.83)mmol/L,差异均有统计学意义(P<0.05)。观察组患者治疗8周后的血TC、TG、LDL-C水平分别为(3.64±0.19)、(1.31±0.64)、(1.60±0.33)mmol/L,均低于对照组患者的(4.19±0.28)、(1.44±0.82)、(2.53±0.66)mmol/L,差异均有统计学意义(P<0.05);观察组患者的血ALT、AST、CK、HDL-C水平与对照组相比,差异均无统计学意义(P>0.05)。结论阿托伐他汀序贯疗法对AMI患者具有较好的调脂效果,值得临床推广使用。

Objective To investigate the application efficacy a of atorvastatin sequential therapy in patients with acute myocardial infarction （AMI）. Methods 132 cases who diagnosed as AMI were divided randomly into observation group and control group with 66 cases in each group,the patients of observation group were treated with atorvastatin sequen- tial therapy,and the patients of control group were treated with atorvastatin routine therapy,20 mg/d,the changes of fast- ing lipid profiles,included TC,TG,LDL-C,HDL-C,ALT,AST,CK of patients was observed after 24 hours,4 weeks and 8 weeks. Results 4 weeks after treatment,the serum TC,TG,LDL-C in observation group were （4.09±0.68）,0.52±0.39）, （2.68±0.90）mmol/L respectively,which were lower than that of control group [（4.81±0.97）,（1.62±0.47）,2.93±0.83）mmol/ L],there were significant difference between the two groups （P〈0.05）;8 weeks after treatment,the serum TC,TG,LDL-C in observation group were （3.64±0.19）,（1.31±0.64）,（1.60±0.33）mmol/L, which were lower than that of control group [（4.19±0.28）,（1.44±0.82）,（2.53±0.66） mmol/L],there were significant difference between the two groups （P〈0.05）.There were no significant difference of the serum AST,ALT,CK,HDL-C between the two groups （P〉0.05）. Conclusion The atorvastatin sequential therapy is showed a better lipid-lowering efficiency,and it is worthy of promotion and application in clinic.