| 摘要: |
| ［摘要］ 目的 评价不同他汀类药物治疗急性心肌梗死（AMI）的临床效果及随访结果。方法 回顾性分析该院168例AMI患者的临床资料，收集在AMI常规治疗下，分别用阿托伐他汀、辛伐他汀和瑞舒伐他汀治疗6个月患者的血脂、血糖、炎性因子和心血管相关功能项目指标改变情况，以及随访6个月药物不良反应和不良心血管事件的发生情况并比较。结果 经治疗后，三种他汀类药物较治疗前能显著降低患者的总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）和超敏C反应蛋白（hs-CRP）水平，升高高密度脂蛋白胆固醇（HDL-C）的浓度（P<0.05）；瑞舒伐他汀治疗后患者的hs-CRP降低程度和HDL-C升高程度较其他两种药物相比差异具有统计学意义（P<0.05）；阿托伐他汀、瑞舒伐他汀治疗可使得患者空腹血糖（FPG）浓度显著升高（P<0.05），瑞舒伐他汀治疗后患者FPG、糖化血红蛋白（HbA1c）升高程度较其他两组相比差异有统计学意义（P<0.05）；三种他汀类药物均可显著改善患者的肱动脉内皮依赖性舒张功能（FMD）（P<0.05），各组间相比差异无统计学意义（P>0.05）；阿托伐他汀、辛伐他汀和瑞舒伐他汀不良药物反应率分别为4.23%、5.77%和4.44%，不良心血管事件发生率分别为5.63%、9.62%和6.67%，各组间相比差异无统计学意义（P>0.05）。结论 不同他汀药物在AMI治疗中有良好的临床效果和安全性，阿托伐他汀、辛伐他汀和瑞舒伐他汀在具体的调脂、抗炎作用和改善外周血管舒张功能作用上大致相似也略有不同，对患者血糖产生的影响也有所差异，应注意个体化用药。 |
| 关键词: 急性心肌梗死 阿托伐他汀 辛伐他汀 瑞舒伐他汀 |
| DOI：10.3969/j.issn.1674-3806.2017.05.15 |
| 分类号:R 542.2 |
| 基金项目: |
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| The clinical effects of different statins on acute myocardial infarction and the follow-up results |
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YU Wei-qing, HUANG Wei-guo
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Department of Critical Care Medicine, the People′s Hospital of Yangdong District in Yangjiang City, Guangdong 529500, China
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| Abstract: |
| ［Abstract］ Objective To study the clinical effects of different statins on acute myocardial infarction(AMI) and the follow-up results.Methods The data of 168 cases with AMI within 2 years were retrospectively analyzed. All the patients received the conventional therapy for AMI. The levels of blood lipid, blood sugar and inflammation factors, and the changes of the cardiovascular function were detected and compared among different groups of the patients who received different statins of atorvastatin, simvastatin and rosuvastatin 6 months after the treatment. The incidences of adverse drug reactions and adverse cardiovascular events were compared among different groups after a follow-up of six months.Results The levels of TC, TG, LDL-C and hs-CRP were decreased significantly meanwhile the level of HDL-C was increased significantly in the patients who received the different statins before the treatment(P<0.05); There were significantly differences among rosuvastatin,atorvastatin and simvastatin in the effects of decreasing hs-CRP level and increasing HDL-C level(P<0.05); Atorvastatin and rosuvastatin could significantly increase the concentration of FPG in the patients(P<0.05). There was a significant difference in the effects of increasing FPG and HbA1c between rosuvastatin groups compared with those in the other two groups.Three kinds of statins could significantly improve FMD(P<0.05), however there was no significant differences among them（P>0.05）. There was no significant difference in the rate of adverse reactions between atorvastatin(4.23%), simvastatin(5.77%) and rosuvastatin(4.44%). There was no significant difference in the incidence of adverse cardiovascular events between atorvastatin(5.63%), simvastatin(9.62%) and rosuvastatin(6.67%)（P>0.05）.Conclusion Atorvastatin, simvastatin and rosuvastatin have similar clinical efficacy and safety in the treatment of AMI and they should be used individually in the patients. |
| Key words: Acute myocardial infarction Atorvastatin Simvastatin Rosuvastatin |
