探讨瑞舒伐他汀、辛伐他汀、阿托伐他汀在ICU急性心梗患者中的应用效果差异

Difference in Application Effect of Rosuvastatin,Simvastatin and Atorvastatin in ICU Patients with Acute Myocardial Infarction

目的:探讨瑞舒伐他汀、辛伐他汀、阿托伐他汀在ICU急性心肌梗死患者救治中的应用效果差异。方法:选取2018年6月-2019年6月本院ICU病房收治的180例老年冠心病急性心梗患者作为研究对象。采用随机数字表法将其分为A、B、C三组,各60例。A组在常规对症治疗基础上应用瑞舒伐他汀治疗,B组在常规治疗基础上应用辛伐他汀治疗,C组在常规治疗基础上应用阿托伐他汀治疗,对比三组急性心梗患者治疗效果及不良反应发生情况。结果:治疗后,三组TC、LDL-C水平均较治疗前降低,HDL-C水平较治疗前升高(P<0.05),但三组TC、LDL-C、HDL-C水平比较,差异均无统计学意义(P>0.05);治疗后,三组TG水平略低于治疗前,但差异均无统计学意义(P>0.05),且三组比较差异无统计学意义(P>0.05)。治疗后,B组Apo-A_(1)、Apo-B、Apo-B/Apo-A_(1)水平较治疗前均改善(P<0.05),且C组Apo-A_(1)水平较治疗前改善(P<0.05);同时治疗前后三组LP_(a)水平比较,差异均无统计学意义(P>0.05)。治疗后,左、右cIMT较治疗前均降低(P<0.05),但三组比较,差异均无统计学意义(P>0.05)。结论:瑞舒伐他汀、辛伐他汀、阿托伐他汀均可用于急性心梗急危重症患者的临床治疗中,可有效改善患者血脂水平及心功能状态,并且药物应用安全性较高,同时辛伐他汀对改善Apo-A_(1)、Apo-B水平具有一定优势,临床应根据实际情况合理选择他汀类药物治疗。

Objective:To explore the difference in the application effect of Rosuvastatin,Simvastatin and Atorvastatin in the treatment of patients with acute myocardial infarction in ICU.Method:A total of 180 elderly patients with acute myocardial infarction with coronary heart disease admitted to ICU wards of our hospital from June 2018 to June 2019 were selected as the research objects.They were divided into three groups by random number table method,A,B and C group,60 cases in each group.A group was treated with Rosuvastatin on the basis of conventional symptomatic treatment,B group was treated with Simvastatin on the basis of conventional treatment,C group was treated with Atorvastatin on the basis of conventional treatment.The therapeutic effect and adverse reactions of patients with acute myocardial infarction among three groups were compared.Result:After treatment,the levels of TC,LDL-C among three groups were all lower than those of before treatment,HDL-C level was higher than that of before treatment(P<0.05),but there were no statistically significant differences in the levels of TC,LDL-C and HDL-C among three groups(P>0.05).After treatment,TG levels in three groups were slightly lower than those of before treatment,but the differences were not statistically significant(P>0.05),there was no statistically significant difference among three groups(P>0.05).After treatment,Apo-A_(1),Apo-B,and Apo-B/Apo-A_(1) levels in B group were all improved compared with those of before treatment(P<0.05),Apo-A_(1) level in C group was improved compared with that of before treatment(P<0.05),there were no significant differences in LP_(a)levels among three groups before and after treatment(P>0.05).Conclusion:Rosuvastatin,Simvastatin,and Atorvastatin can be used in the clinical treatment of critically ill patients with acute myocardial infarction,which can effectively improve the blood lipid level and cardiac function status of patients,the drug application is safer.The statin therapy should be selected reasonably according to the actual situation.