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目的:探讨辛伐他汀对预防合并糖尿病的老年急性心肌梗死再发的疗效并分析可能机制,以期为临床诊疗提供参考。方法:分析2012年1月-2014年1月在某院通过保守治疗临床治愈的老年急性心肌梗死患者的临床资料,所有患者均合并2型糖尿病,依据患者心肌梗死愈后治疗药物不同分为观察组(辛伐他汀)及对照组。治疗随访1年后分析疗效及可能机制。结果:本研究共纳入患者92例,其中观察组49例,对照组43例。治疗后观察组患者TC、TG及LDL-C水平均显著低于对照组,差异具有统计学意义(P<0.05);而HDL-C水平显著高于对照组(P<0.05)。观察组NO水平及FMD显著高于对照组,而ET-1水平显著低于对照组,差异均具有统计学意义(P<0.05)观察组患者CRP及IL-6水平均显著低于对照组,差异具有统计学意义(P<0.05)。观察组累积1年心肌梗死再发率显著低于对照组,差异具有统计学意义(8.16%,4/49 vs.25.58%,11/43;Log-rankΧ2=4.954,P=0.026)。结论:辛伐他汀可有效预防合并糖尿的老年急性心肌梗死再发,可能与其调节血脂、血管功能及炎症反应有关。
Objective: To investigate the effect of simvastatin on the prevention of recurrent senile acute myocardial infarction complicated with diabetes mellitus and to analyze the possible mechanism, in order to provide a reference for clinical diagnosis and treatment. Methods: The clinical data of elderly patients with acute myocardial infarction who underwent conservative treatment in a hospital from January 2012 to January 2014 were analyzed. All patients were complicated with type 2 diabetes mellitus, and were divided into two groups according to the different treatment of patients with myocardial infarction Group (simvastatin) and control group. One year after treatment, the curative effect and possible mechanism were analyzed. Results: A total of 92 patients were enrolled in this study, including 49 cases in the observation group and 43 cases in the control group. After treatment, the levels of TC, TG and LDL-C in the observation group were significantly lower than those in the control group (P <0.05), while the levels of HDL-C in the observation group were significantly higher than those in the control group (P <0.05). The levels of NO and FMD in the observation group were significantly higher than those in the control group, while the levels of ET-1 in the observation group were significantly lower than those in the control group (P <0.05). The levels of CRP and IL-6 in the observation group were significantly lower than those in the control group The difference was statistically significant (P <0.05). The cumulative 1-year myocardial infarction recurrence rate in the observation group was significantly lower than that in the control group (8.16%, 4/49 vs.25.58%, 11/43; Log-rankΧ2 = 4.954, P = 0.026). Conclusion: Simvastatin can prevent the relapse of senile acute myocardial infarction complicated with diabetes mellitus, which may be related to the regulation of blood lipids, vascular function and inflammatory response.