摘要
目的探讨阿托伐他汀序贯疗法对急性心肌梗死(AMI)溶栓治疗后心肌标志物、血脂以及主要心脏不良事件的影响。方法将42例接受急诊溶栓的AMI患者随机分为治疗组和对照组,治疗组19例患者给予阿托伐他汀钙术前80mg顿服,术后40mg,每晚1次口服1个月,之后给予20mg长期口服;对照组23例患者仅术后给予阿托伐他汀钙20mg,每晚1次口服。于术前及术后24h、72h、1周、2周测定血清心肌标志物水平;于术前及术后1个月、2个月、3个月进行血液生化检查,观察血脂变化;术后3个月每月随访主要心脏不良事件。结果术前、术后24h、术后1周、术后2周两组患者肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)比较,差异均无统计学意义(P>0.05);术后72h两组上述指标比较,差异均有统计学意义(P<0.05)。术前两组患者三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)比较,差异无统计学意义(P>0.05);术后1个月、2个月、3个月,治疗组TC、LDL-C明显低于对照组,差异有统计学意义(P<0.05);两组TG及HDL-C比较,差异无统计学意义(P>0.05)。所有患者未出现心脏不良事件。结论 AMI患者行急诊溶栓治疗,使用阿托伐他汀序贯疗法对心肌具有更强的保护作用,可以更好地降低血脂,预防主要心脏不良事件发生。
Objective To investigate Effects of atorvastatin therapy in acute myocardial infarction （AMI） after throm- bolytic therapy for myocardial markers, lipids and major adverse cardiac events. Methods 42 cases underwent emergency thrombolytic therapy for patients with AMI were randomly divided into treatment group and control group, 19 cases in the treat- ment group were given atorvastatin calcium preoperative 80mg Dayton clothing, after 40mg, every night 1 orally for 1 months, after giving 20mg long - term oral; 23 cases in control group only after giving a support atorvastatin calcium 20mg, orally 1 times every night. In the preoperative and postoperative 24h, 72h, 1 weeks, 2 weeks in determination of serum cardiac markers lev- el; in the preoperative and postoperative 1 months, 2 months, 3 months for blood biochemistry examination, observation of changes of blood lipids; after 3 month follow - up of major adverse cardiac events. Results Preoperative, postoperative 24h, after 1 weeks, 2 weeks after operation in two patients with creatine kinase （CK）, creatine kinase isoenzyme （CK -MB）, lac- tate dehydrogenase （ LDH）, the differences were not statistically significant （ P 〉 0. 05 ） ; 72h after operation in the two groups of the index is compared, the differences were statistically significant （P 〈 0. 05）. Preoperatively and two patients three triglyeer- ides （TG）, total cholesterol （TC）, low density lipoprotein cholesterol （ LDL - C）, high density lipoprotein cholesterol （ HDL - C）, the difference was not statistically significant （P 〉 0. 05） ; after 1 months, 2 months, 3 months, group TC, LDL - C was significantly lower than that in the control group, there were statistically significant differences in （P 〈 0. 05） ; two groups of TG and HDL - C is compared, the difference was not statistically significant （P 〉 0. 05 ）. All the patients without any adverse cardiac events. Conclusion Taking atorvastatin sequential therapy in patient with AMI after thrombolysis contributes to protect myocardium, decrease blood fats, prevent major adverse cardiac events.
出处
《实用心脑肺血管病杂志》
2012年第12期1939-1941,共3页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
急性心肌梗死
阿托伐他汀
序贯疗法
Myocardial infarction
Atorvastatin
Sequential therapy
