不同剂量阿托伐他汀联合双抗血小板治疗急性心肌梗死的效果观察

Observation on the efficacy of different doses of atorvastatin combined with double anti-platelet therapy on acute myocardial infarction

目的研究不同剂量阿托伐他汀联合双抗血小板治疗急性心肌梗死(AMI)的疗效。方法92例急性心肌梗死患者,采用随机数表法分为对照组和观察组,各46例。对照组给予标准剂量的阿托伐他汀和双抗血小板药物治疗,观察组给予大剂量的阿托伐他汀和双抗血小板药物治疗。比较两组患者治疗前后的血脂指标[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、心功能指标[左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)]、血清D-二聚体(D-dimer)、超敏C反应蛋白(hs-CRP)水平,不良事件发生率。结果治疗后,两组患者的TC、TG、LDL-C水平低于本组治疗前,HDL-C水平高于本组治疗前,且观察组患者的TC(5.60±0.37)mmol/L、TG(3.65±0.86)mmol/L、LDL-C(2.78±0.12)mmol/L低于对照组的(6.12±0.34)、(4.56±0.81)、(3.31±0.43)mmol/L,HDL-C(1.52±0.39)mmol/L高于对照组的(1.35±0.30)mmol/L,差异具有统计学意义(P<0.05)。治疗后,两组患者的LVEDV、LVESV、D-dimer、hs-CRP水平低于本组治疗前,且观察组患者的LVEDV(102.14±35.71)ml、LVESV(57.35±6.76)ml、D-dimer(0.23±0.18)mg/L、hs-CRP(5.22±0.25)mg/L低于对照组的(117.28±35.66)ml、(63.35±3.10)ml、(0.37±0.22)mg/L、(7.14±0.35)mg/L,差异具有统计学意义(P<0.05)。观察组患者的不良事件发生率低于对照组,但差异无统计学意义(P>0.05)。结论大剂量阿托伐他汀联合双抗血小板在急性心肌梗死的治疗中不仅效果显著,且安全性高,还具有明显的降脂疗效和抗炎症效果。

Objective To study the efficacy of different doses of atorvastatin combined with double antiplatelet therapy on acute myocardial infarction(AMI).Methods A total of 92 patients with acute myocardial infarction were divided into control group and observation group by random numerical table,each with 46 cases.The control group was treated with standard-dose atorvastatin and double antiplatelet drugs,and the observation group was treated with high-dose atorvastatin and double antiplatelet drugs.Both groups were compared in terms of blood lipid indexes[total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)],cardiac function indexes[left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV)],serum D-dimer(D-dimer),highsensitivity C-reactive protein(hs-CRP)before and after treatment,incidence of adverse events.Results After treatment,TC,TG,and LDL-C of the two groups were lower than those of this group before treatment,and HDL-C was higher than that of this group before treatment;TC(5.60±0.37)mmol/L,TG(3.65±0.86)mmol/L and LDL-C(2.78±0.12)mmol/L of the observation group were lower than(6.12±0.34),(4.56±0.81),(3.31±0.43)mmol/L of the control group,and HDL-C(1.52±0.39)mmol/L was higher than(1.35±0.30)mmol/L of the control group;all the differences were statistically significant(P<0.05).After treatment,LVEDV,LVESV,D-dimer,and hs-CRP of the two groups were lower than those of this group before treatment,and LVEDV(102.14±35.71)ml,LVESV(57.35±6.76)ml,D-dimer(0.23±0.18)mg/L,hs-CRP(5.22±0.25)mg/L of the observation group were lower than(117.28±35.66)ml,(63.35±3.10)ml,(0.37±0.22)mg/L,(7.14±0.35)mg/L of the control group;all the differences were statistically significant(P<0.05).The incidence of adverse events in the observation group was lower than that in the control group,but the difference was not statistically significant(P>0.05).Conclusion High-dose atorvastatin in combination with double antiplatelet drugs is not only effective and safe in the treatment of acute myocardial infarction,but also has significant lipid-lowering and anti-inflammatory effects.