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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

2014年第5期

页码:

558-561,565

栏目:

临床研究

出版日期:

2014-05-25

文章信息/Info

Title:

Rosuvastatin therapy for patients with acute myocardial infarction

作者:

牛俊芳; 李 佳

(哈尔滨医科大学第一附属医院CCU，黑龙江 哈尔滨 150001)

Author(s):

NIU Jun-fang;  LI Jia

(Deparment of Cardiology, First Affiliated Hospital, Harbin Medical University, Harbin 150001, Heilongjiang, China)

关键词:

心肌梗死; 瑞舒伐他汀; 降脂疗效; 安全性评估

Keywords:

acute myocardial infarction;  rosuvastatin;  lipid-lowering effect;  safety evaluation

分类号:

R541.4

DOI:

-

文献标识码:

A

摘要:

目的:探讨不同剂量瑞舒伐他汀治疗急性心肌梗死(AMI)患者的降脂疗效和安全性的评价。方法： 选取在我院冠心病重症监护室2012年1月~9月的232例AMI患者，分成强化治疗（强化组）和普通剂量组(常规组），强化组：178例，瑞舒伐他汀 20 mg/d；常规组：54例，瑞舒伐他汀 10 mg/d。对出院时丙氨酸转移酶(ALT)和(或)门冬氨酸转移酶(AST)升高超过正常值3倍以上的患者服用剂量减半或停用，即强化组患者瑞舒伐他汀10 mg/d，常规组患者暂时停用瑞舒伐他汀。比较入院时、出院时及随访1个月、3个月的血脂指标、超敏C反应蛋白(hs-CRP)、肝肾功能变化及主要心血管事件的发生情况。结果： ①两组的总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白B（ApoB）均有显著下降(P<0.05)，其中强化组在出院1个月时降低LDL-C的水平更显著（P<0.05）。②两组患者的hs-CRP出院后均有显著下降，但两组间比较差异无统计学意义。③出院后患者返院复查肝肾功能，两组比较差异无统计学意义。④对主要心血管事件进行3个月随访，强化组无患者死亡，常规组3例死亡，两组比较差异有统计学意义（P<0.05）。结论： AMI患者早期应用瑞舒伐他汀强化治疗更有效、更安全。

Abstract:

AIM:To assess the safety and the lipid-lowering efficacy of different doses of rosuvastatin in patients with acute myocardial infarction (AMI). METHODS: A total of 232 AMI patients admitted to our hospital from January 2012 to September were divided into intensive treatment group (group A, n=178, rosuvastatin 20 mg/day) and the common dose group (group B, n=54, rosuvastatin 10 mg/day). Patients in group A with increased liver enzyme level (three times higher than normal) at discharge took rosuvastatin 10 mg daily and patients in group B under the same conditions stopped taking rosuvastatin. Lipid profiles, high-sensitivity C-reactive protein, liver and kidney function, and major cardiovascular events were compared at admission, discharge, 1 month and 3 months after discharge. RESULTS: Total cholesterol (TC), LDL-C, apolipoprotein B (apoB) in both groups significantly decreased (P<0.05), and LDL-C level was more significantly decreased 1 month after discharge in group A (P<0.05). Hs-CRP significantly decreased after discharge, with no statistical difference between groups. After discharge, no statistical difference was found in liver and kidney functions between groups. Three-month follow-up showed statistical differences in major cardiovascular events between group A and group B (death, 0 vs. 3, P<0.05). CONCLUSION: Intensive rosuvastatin therapy is safe and more effective for patients with AMI.

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备注/Memo

备注/Memo:

收稿日期：2014-01-03.
通讯作者：李佳,主任医师，主要从事急性心梗、心衰的诊治等心内科危重症研究 Email：liliahrb@hotmail.com
作者简介：牛俊芳,硕士生 Email：niu110735@163.com

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更新日期/Last Update: 2014-06-05