辛伐他汀对急性心肌梗死患者颈动脉斑块的影响

The Effect of Simvastatin on Acute Myocardial Infarction in Patients with Carotid Artery plaque

目的探讨辛伐他汀对急性心肌梗死(AMI)患者颈动脉斑块的作用及血管内皮功能改善的疗效。方法将我院近4年来我院治疗的AMI患者177例随机分成对照组(87例)及观察组(90例),两组患者均首先严格的按照AMI的常规治疗,观察组在常规治疗的基础上于AMI发病24小时内开始服用辛伐他汀治疗,对照组则未给予其他治疗,一个疗程为3个月。两组患者均于急性心肌梗死后24小时内及3个月时,对两组患者均应用美国HPsonos 4500超声仪检测肱动脉的血管内皮依赖性舒张功能(FMD)和非内皮依赖性舒张功能(NMD)、颈动脉粥样硬化斑块积分、颈动脉内膜中层厚度(IMT)等指标。结果经观察治疗一个疗程后,观察组患者的FMD值明显好于对照组及治疗前,而IMT指标明显好于对照组,患者的颈动脉粥样硬化斑块积分得到显著改善,两组患者的数据差异显著,具有统计学意义(P<0.05)。检查指标显示FMD与IMT呈负相关(P<0.05)。结论动脉粥样硬化的程度与AMI的发生关系紧密。AMI患者的颈动脉粥样硬化的程度可间接反映冠状动脉的硬化程度,辛伐他汀可起到稳定动脉斑块的作用,可显著改善患者的血管内皮功能,长期应用对急性心肌梗死的近期及远期预后可起到积极的作用。

Objective To investigate the effect of simvastatin on acute myocardial infarction（ AMI）effect on vascular endothelial function and carotid artery plaque in patients with improved. Methods in our hospital in recent 4 years in our hospital for treatment of 177 patients with AMI were randomly divided into control group（ 87 cases） and observation group（ 90 cases）,two groups of patients are first strictly in accordance with the conventional treatment of AMI,observation group on the basis of conventional therapy in AMI within 24 hours of onset started taking simvastatin he Ting therapy,while the control group without treatment,a treatment for 3 months. Two groups of patients with acute myocardial infarction after 24 hours and at 3 months,two patients were used for HP detection of 4500 SONOS America brachial artery ultrasound vascular endothelial dependent diastolic function（ FMD） and non endothelial dependent diastolic function（ NMD）,carotid atherosclerosis plaque score,carotid artery intima-media thickness（ IMT） index. Results after the treatment were observed after one course of treatment,patients in the observation group FMD value was significantly better than the control group and before treatment,and the IMT index was significantly better than the control group,carotid atherosclerotic plaque in patients with integral has been significantly improved,the differences between the two groups were significant data,with statistical significance（ P〈0. 05）. Check the index shows a negative correlation between FMD and IMT（ P〈0. 05）. Conclusion the relationship between the incidence of AMI and degree of atherosclerosis closely. AMI patients with carotid atherosclerosis degree can indirectly reflect the degree of coronary artery sclerosis,simvastatin can play a stabilizing atherosclerotic plaque,narrowed artery plaque fade and arterial plaque can significantly improve endothelial function of patients,applied to the positive role of short term and long term prognosis of acute myocardial infarction can be long-term.