常规与负荷剂量阿托伐他汀在治疗急性心肌梗死中的疗效对比

Effects of conventional and loading dose of atorvastatin in the treatment of acute myocardial infarction

目的探讨与比较阿托伐他汀的常规与负荷剂量在介入治疗急性心肌梗死中的疗效。方法收集2015年6月至2016年6月入院的100例行介入治疗的急性心肌梗死患者随机分为两组，常规剂量组患者给予常规剂量阿托伐他汀，负荷剂量组患者则给予负荷剂量阿托伐他汀，比较两组患者相关临床指标、不良心血管事件与药物不良反应发生率。结果常规剂量组患者术后24h的TC、TG、LDL-C、CK-MB、cTnI、hs-CRP、IL一6、Cr与ALT水平组间比较均显著高于负荷剂量组，HDL-C水平组间比较显著低于负荷剂量组，差异均有统计学意义（均P〈0．01）；常规剂量组患者30dMACE发生率明显高于对照组，差异有统计学意义（P〈0．05）；两组患者治疗期间总体药物不良反应发生率比较差异均无统计学意义（均P〉0．05）。结论负荷剂量的阿托伐他汀在降低介入治疗术后炎症反应与稳定血脂的效果优于常规剂量，并减少心血管事件发生概率，且并未提高药物不良反应，安全性较高，借鉴意义重大。

Objective To compare the efficacy of conventional and loading dose of atorvastatin in the treatment of acute myocardial infarction （AMI）. Methods A total of 100 patients with acute myocardial infarction who were admitted between June 2015 and June 2016 were randomly divided into two groups. The patients in the conventional dose group were given conventional dose of atorvastatin, while the patients in the loading dose group were given loading dose of atorvastatin. Clinical indicators, adverse cardiovascular events, and adverse drug reactions were compared between the two groups. Results The levels ofTC, TG, LDL-C, CK-MB, cTn I , hs-CRP, IL-6, Cr, and ALT in the conventional dose group postoperative 24 h were significantly higher than those in the loading dose group, the level of HDL-C was lower （P〈0.01）. The incidence of 30-day MACE in the conventional dose group was significantly higher than that in the loading dose group （P〈0.05）. There was no statistically significant difference in the incidence of adverse drug reactions between the two groups （P〉0.05）. Conclusion Loading dose of atorvastatin can decrease the incidence of cardiovascular events and the adverse effects of atorvastatin on the inflammatory response and blood lioid stability after interventional therapy, with higher safety.