匹伐他汀与阿托伐他汀强化治疗在急性心肌梗死患者经皮冠状动脉介入术中应用效果的对比研究

Application Effect on PCI in Patients with Acute Myocardial Infarction between Pitavastatin and Atorvastatin Intensive Treatment:a Comparative Study

目的比较匹伐他汀与阿托伐他汀强化治疗在急性心肌梗死患者经皮冠状动脉介入术(PCI)中的应用效果。方法选取2015年3月—2016年2月于北京市垂杨柳医院行PCI的急性心肌梗死患者121例,采用随机数字表法分为匹伐他汀组61例与阿托伐他汀组60例。在常规治疗基础上,匹伐他汀组患者于PCI前予以匹伐他汀强化治疗;阿托伐他汀组患者于PCI前予以阿托伐他汀强化治疗。比较两组患者治疗前及治疗3、6个月血脂指标,并观察两组患者治疗期间主要不良心血管事件(MACE)和不良反应发生情况。结果时间与方法在总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)上无交互作用(P>0.05);时间在TC、LDL-C、HDL-C上主效应显著(P<0.05),在TG上主效应不显著(P>0.05);方法在TC、TG、LDL-C、HDL-C上主效应不显著(P>0.05);治疗3、6个月两组患者TC、LDL-C低于治疗前,HDL-C高于治疗前(P<0.05)。治疗期间两组患者MACE发生率比较,差异无统计学意义(P>0.05),而匹伐他汀组患者不良反应发生率低于阿托伐他汀组(P<0.05)。结论匹伐他汀与阿托伐他汀强化治疗在急性心肌梗死患者PCI中的应用效果相当,均可有效改善患者血脂代谢、减少MACE的发生,而与阿托伐他汀强化治疗比较,匹伐他汀强化治疗的安全性较高。

Objective To compare the application effect on PCI in patients with acute myocardial infarction between pitavastatin and atorvastatin intensive treatment. Methods A total of 121 acute myocardial infarction patients undergoing PCI were selected in Beijing Chuiyangliu Hospital from March 2015 to February 2016, and they were divided into pitavastatin group（n=61） and atorvastatin group（n=60） according to random number table. Based on conventional treatment, patients in pitavastatin group received pitavastatin intensive treatment before PCI, while patients in atorvastatin group received atorvastatin intensive treatment before PCI. Blood lipids index was compared between the two groups before treatment, 3 and 6 months after treatment, incidence of MACE and adverse reactions was observed during treatment, respectively. Results No interaction was found between time and method in TC, TG, LDL-C or HDL-C（P〉0.05）; main effect of time was significant in TC, LDL-C and HDL-C, respectively（P〈0.05）, was not significant in TG（P〉0.05）; main effect of method was not significant in TC, TG, LDL-C or HDL-C（P〉0.05）; 3 and 6 months after treatment, TC and LDL-C in the two groups were statistically significantly lower than those before treatment, while HDL-C in the two groups was statistically significantly higher than that before treatment, respectively（P〈0.05）. No statistically significant differences of incidence of MACE was found between the two groups during treatment（P〉0.05）, while incidence of adverse reactions in pitavastatin group was statistically significantly lower than that in atorvastatin group（P〈0.05）. Conclusion Pitavastatin intensive treatment has similar application effect with atorvastatin intensive treatment on PCI in patients with acute myocardial infarction, both them can effectively adjust the blood lipid metabolism and reduce the risk of MACE, but compared with atorvastatin intensive treatment, pitavastatin intensive treatment has higher safety.