天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (3): 314-317.doi: 10.11958/20160967

• 临床研究 • 上一篇    下一篇

瑞舒伐他汀治疗对急性 ST 段抬高型心肌梗死患者短期预后的影响

王丹丹， 李秀， 王蔓蔓， 刘相丽△   

  1. 天津医科大学第二医院心脏科 （邮编 300211）
  • 收稿日期:2016-09-07 修回日期:2017-02-28 出版日期:2017-03-15 发布日期:2017-03-21
  • 通讯作者: 刘相丽 E-mail:wangdandan9021@sina.com

Effects of rosuvastatin therapy on short-term prognosis of myocardial infarction in patients with acute ST segment elevation

WANG Dan-dan, LI Xiu, WANG Man-man, LIU Xiang-li△   

  1. Department of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China
  • Received:2016-09-07 Revised:2017-02-28 Published:2017-03-15 Online:2017-03-21
  • Contact: LIU Xiang-li E-mail:wangdandan9021@sina.com

PDF (PC)

3721

摘要： 摘要： 目的 探讨不同剂量瑞舒伐他汀治疗急性 ST 段抬高型心肌梗死（STEMI）患者的短期治疗效果及安全性。方法 收集 115 例天津医科大学第二医院心内科住院的 STEMI 患者， 根据患者口服瑞舒伐他汀剂量不同将其 分为低剂量组 （n=44， 5 mg/次， 1 次/d） 和中剂量组 （n=71， 10 mg/次， 1 次/d）， 2 组均坚持他汀治疗并维持至出院后至少1 个月。比较 2 组治疗前后总胆固醇（TC）、 三酰甘油（TG）、 低密度脂蛋白胆固醇（LDL-C）、 高密度脂蛋白胆固醇（HDL-C）、 丙氨酸转氨酶（ALT）、 天冬氨酸转氨酶（AST）等指标； 并记录患者主要心血管不良事件（MACE）和药物不良反应的发生情况。结果 治疗前和治疗 1 个月后 2 组间血脂及肝功能指标差异均无统计学意义； 2 组治疗 1 个月后 TC、 LDL-C、 ALT 和 AST 均较治疗前明显下降（P＜0.05）， TG、 HDL-C 与治疗前差异无统计学意义。中剂量组发生梗死后心力衰竭和心绞痛比例均低于低剂量组 （P＜0.05）， 恶性心律失常比例与低剂量组差异无统计学意义， 2 组均无靶血管再灌注治疗及死亡病例。随访期间未见明显药物不良反应发生。结论 STEMI 患者在常规治疗基础上给予 10 mg/d 他汀治疗与 5 mg/d 他汀治疗的降脂效果相当， 但能减少患者 MACE 事件发生率， 改善患者预后。

关键词: 心肌梗死, 预后, 急性 ST 段抬高型心肌梗死, 瑞舒伐他汀, 主要心血管不良事件, 药物不良反应

Abstract: Abstract: Objective To investigate the therapeutic effects and adverse drug reactions of different doses of rosuvastatin in patients with acute ST segment elevation myocardial infarction (STEMI). Methods A total of 115 patients with STEMI were collected from Department of Cardiology, the Second Hospital of Tianjin Medical University. According to different oral doses of rosuvastatin, patients were divided into two groups including 5 mg/d rosuvastatin treatment group (lowdose group, n=44) and 10 mg/d Rosuvastatin treatment group (moderate- dose group, n=71). Patients of two groups were treated with Rosuvastatin at least 1 month after discharge. Data of total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were analyzed and compared before and after treatment between two groups. The major cardiovascular adverse events (MACE) and adverse reactions were recorded in two groups of patients. Results There were no significant differences in blood lipid and liver function levels before and after one month treatment between the two groups. After one month treatment, levels of TC, LDL- C, ALT and AST were significantly decreased in both groups of patients compared with those before treatment (P＜0.05). There were no significant differences in levels of TG, and HDL-C before and after treatment between two groups. The incidence of MACE (heart failure and angina pectoris) was significantly lower in moderate-dose group than that in low-dose group (P＜0.05). There was no significant difference in the proportion of malignant arrhythmia between the moderate-dose group and the low-dose group (P＜0.05). No target vessel repair and death were found in the two groups. No obvious adverse drug reactions were found during the follow-up period. Conclusion The hypolipidemic effects are epuivalent between 5 mg/d rosuvastatin and 10 mg/d on the basis of conventional treatment for STEMI patients, but the moderate dose can reduce the incidence of MACE and improve prognosis.

Key words: myocardial infarction, prognosis, ST segment elevation acute myocardial infarction, Rosuvastatin, major adverse cardiovascular events, adverse drug reactions