依折麦布联合瑞舒伐他汀治疗早发冠状动脉粥样硬化性心脏病急性心肌梗死的临床研究

Clinical study of ezetimibe combined with rosuvastatin in the treatment of acute myocardial infarction in patients with early onset coronary atherosclerotic heart disease

目的分析依折麦布联合瑞舒伐他汀治疗早发冠状动脉粥样硬化性心脏病(CHD)急性心肌梗死的临床治疗效果。方法选取2019年1月至2020年12月上海市中医医院心内科收治的100例早发CHD急性心肌梗死患者,男54例,女46例,年龄(56.2±6.3)岁,年龄范围为45~77岁。按照治疗方式不同分为依折麦布组与联合用药组,每组50例。两组患者均基于常规治疗措施,依折麦布组采用依折麦布片治疗,联合用药组采用依折麦布片联合瑞舒伐他汀片治疗。比较两组患者临床治疗效果、治疗前后的血脂指标、血清炎症因子指标及不良反应发生情况。结果联合用药组患者的治疗总有效率[92.0%(46/50)]高于依折麦布组[76.0%(38/50)],差异有统计学意义(χ^(2)=4.762,P=0.029)。治疗后,联合用药组甘油三酯[(1.4±0.3)mmol/L]、总胆固醇[(3.0±0.6)mmol/L]均低于依折麦布组[(2.1±0.5)mmol/L、(4.0±0.8)mmol/L],联合用药组肿瘤坏死因子-α[(20.6±5.2)ng/L]、白细胞介素-6[(120.3±17.5)ng/L]均低于依折麦布组[(35.4±6.0)ng/L、(161.6±20.5)ng/L],差异均有统计学意义(P<0.05)。依折麦布组不良反应发生率[8.0%(4/50)]与联合用药组[6.0%(3/50)]比较,差异无统计学意义(χ^(2)=1.238,P=0.114)。结论依折麦布联合瑞舒伐他汀的治疗方案具有较高的治疗效果与安全性,能够有效降低CHD患者的血脂水平,延缓病情进展,从而提高急性心肌梗死的治疗效果,值得推广使用。

Objective To analyze the clinical effect of ezetimibe combined with rosuvastatin in the treatment of early onset coronary atherosclerotic heart disease(CHD)acute myocardial infarction.Methods A total of 100 patients with acute myocardial infarction with early CHD were enrolled in department of Cardiology in Shanghai Traditional Chinese Medicine Hospital from January 2019 to December 2020,including 54 males and 46 females,aged(56.2±6.3)years old,ranging from 45 to 77 years old.According to the treatment methods,they were divided into ezetimibe group and combination group,with 50 patients in each group.Patients in both groups were treated with conventional treatment measures,ezetimibe group was treated with ezetimibe tablets,and combination group was treated with ezetimibe tablets combined with rosuvastatin tablets.The clinical treatment effect,serum lipid indexes,serum inflammatory factors indexes and the incidence of adverse reactions were compared between the two groups before and after treatment.Results The total effective rate in the combination group[92.0%(46/50)]was higher than that in the ezetimibe group[76.0%(38/50)],and the difference was statistically significant(χ^(2)=4.762,P=0.029).After treatment,triglycerides[(1.4±0.3)mmol/L]and total cholesterol[(3.0±0.6)mmol/L]in the combination group were lower than those in the ezetimibe group[(2.1±0.5)mmol/L,(4.0±0.8)mmol/L].Tumor necrosis factor-α[(20.6±5.2)ng/L]and interleukin-6[(120.3±17.5)ng/L]in the combination group were lower than those in the ezetimibe group[(35.4±6.0)ng/L,(161.6±20.5)ng/L],with statistical significance(P<0.05).There was no significant difference in the incidence of adverse reactions between ezeimibe group[8.0%(4/50)]and combination group[6.0%(3/50)],(χ^(2)=1.238,P=0.114).Conclusion Ezetimibe combined with rosuvastatin has high efficacy and safety,can effectively reduce the level of blood lipid in patients with CHD,delay the progression of the disease,so as to improve the treatment effect of acute myocardial infarction,and is worthy of promotion.