不同剂量瑞舒伐他汀结合依折麦布治疗急性心肌梗死的效果及安全性分析

Effect and Safety of Different Doses of Rosuvastatin Combined with Ezetimibe in the Treatment of Acute Myocardial Infarction

目的探究不同剂量瑞舒伐他汀结合依折麦布治疗急性心肌梗死(AMI)的效果及安全性。方法将2018年10月—2020年06月就诊的63例AMI患者随机分为对照组、常规剂量联合组、大剂量联合组各21例,对照组应用10 mg瑞舒伐他汀治疗,常规剂量联合组在对照组基础上联用依折麦布治疗,大剂量联合组采用20 mg瑞舒伐他汀联合依折麦布治疗。比较治疗前及治疗7 d后三组血清B型利钠肽原(ProBNP)、C-反应蛋白(CRP)、血沉(ESR)水平,比较治疗前及治疗1个月后三组血脂水平,比较治疗前及治疗12周后三组心功能变化,比较三组治疗后12周内心血管不良事件发生情况及药物不良反应发生情况。结果治疗7 d后,三组ProBNP、CRP、ESR均较治疗前显著降低(P<0.05),其中大剂量联合组明显低于对照组、常规剂量联合组(P<0.05)。治疗1个月后,三组甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)均较治疗前显著降低(P<0.05),其中大剂量联合组明显低于对照组、常规剂量联合组(P<0.05);三组高密度脂蛋白胆固醇(HDL-C)均较治疗前无显著变化,且组间差异无统计学意义(P>0.05)。治疗12周后,三组左心室射血分数(LVEF)均较治疗前降低(P<0.05),大剂量联合组LVEF明显高于对照组、常规剂量联合组(P<0.05);三组左室舒张期末内径(LVEDD)、左室收缩期末内径(LVESD)均较治疗前扩大(P<0.05),组间差异无统计学意义(P>0.05)。治疗12周内,三组心血管不良事件总发生率、药物不良反应发生率差异无统计学意义(P>0.05)。结论应用20 mg瑞舒伐他汀联合依折麦布治疗AMI可于短期内有效发挥调脂、抗心肌损伤、抗炎的作用,用药期间需严密监测不良反应发生情况。

Objective To explore the effect and safety of different doses of Rosuvastatin combined with Ezetimibe in the treatment of acute myocardial infarction(AMI).Methods 63 patients with AMI treated in the hospital from October 2018 to June 2020 were randomly divided into control group,conventional-dose combined group and high-dose combined group,with 21 cases in each group.The control group was treated with 10 mg Rosuvastatin,and the conventional-dose combined group was combined with Ezetimibe on the basis of the control group,and the high-dose combined group was given 20 mg Rosuvastatin combined with Ezetimibe.The levels of serum pro-brain natriuretic peptide(ProBNP),C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)before treatment and after 7 d of treatment and the levels of blood lipids before treatment and after 1 months of treatment were compared among the three groups.The changes in cardiac function were compared before treatment and after 12 weeks of treatment in the three groups.The occurrence of adverse cardiovascular events and occurrence of adverse drug reactions in the three groups were compared at 12 weeks after treatment.Results After 7 d of treatment,the ProBNP,CRP and ESR in three groups significantly decreased compared with those before treatment(P<0.05),and the three indicators in high-dose combined group were significantly lower than those in control group and conventional-dose combined group(P<0.05).After 1 month of treatment,the levels of triglyceride(TG),total cholesterol(TC)and low-density lipoprotein cholesterol(LDL-C)in the three groups were obviously reduced compared to before treatment(P<0.05),and the levels were significantly lower in high-dose combined group than those in control group and conventional-dose combined group(P<0.05).There was no significant change in high-density lipoprotein cholesterol(HDL-C)among the three groups compared with that before treatment,and there was no significant difference among the groups(P<0.05).After 12 weeks of treatment,the left ventricular ejection fraction(LVEF)in the three groups decreased compared with that before treatment(P<0.05),and LVEF in high-dose combined group was significantly higher than that in control group and conventional-dose combined group(P<0.05).Compared with before treatment,the left ventricular end diastolic diameter(LVEDD)and left ventricular end systolic diameter(LVESD)in the three groups increased(P<0.05),and there were no significant differences among the groups(P>0.05).Within 12 weeks of treatment,there were no significant differences in the total incidence rate of adverse cardiovascular events and incidence rates of adverse drug reactions among the three groups(P>0.05).Conclusion The application of 20 mg Rosuvastatin combined with Ezetimibe in the treatment of AMI can effectively play the roles of lipid regulation,anti-myocardial injury and anti-inflammation in a short term,and it is necessary to closely monitor the occurrence of adverse reactions during medication.