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目的观察急性心肌梗死患者应用阿托伐他汀强化治疗的疗效。方法 98例急性心肌梗死患者随机分为强化治疗组(阿托伐他汀40mg/d)和标准治疗组(阿托伐他汀20mg/d),于治疗前、治疗2月测定患者血脂,采用ELISA法测定hs-CRP、MMP-9,同时观察两组患者终点事件发生率。结果两组患者治疗前后血脂水平相比有统计学差异,治疗后2月TC、TG、LDL-C均低于治疗前、HDL-C高于治疗前。但2月后标准治疗组与强化治疗组相比,血脂水平无统计学意义;两组患者治疗前后hs-CRP、MMP-9相比有统计学差异,治疗后低于治疗前(P<0.05)。2月后强化治疗组与标准治疗组相比,hs-CRP、MMP-9水平有统计学意义,强化治疗组hs-CRP、MMP-9均低于标准治疗组(3.46±1.82 vs 4.52±2.71,P<0.05,252.7±164.1 vs 321.62±178.46,P<0.05);两组患者终点事件相比有统计学差异,强化治疗组治疗效果优于标准治疗组。强化治疗组患者死亡率、再次心肌梗死发生率、心绞痛发生率、再入院率低于标准治疗组,强化治疗组射血分数高于标准治疗组(P<0.05)。结论阿托伐他汀强化治疗可明显改善急性心肌梗死患者的近期预后,这种预后的改善与他汀类药物的调脂外作用相关。
Objective To observe the therapeutic effect of atorvastatin in patients with acute myocardial infarction. Methods 98 patients with acute myocardial infarction were randomly divided into intensive treatment group (atorvastatin 40mg / d) and standard treatment group (atorvastatin 20mg / d), before treatment, The hs-CRP and MMP-9 levels were measured and the incidence of end-point events was observed in both groups. Results Before and after treatment, there was a significant difference in blood lipid levels between the two groups. The levels of TC, TG and LDL-C in 2 months after treatment were lower than those before treatment and HDL-C was higher than before treatment. However, there was no significant difference in the level of serum lipids between the standard treatment group and the intensive treatment group after 2 months. The levels of hs-CRP and MMP-9 in the two groups before treatment were significantly lower than those before treatment (P <0.05) ). Compared with the standard treatment group, the levels of hs-CRP and MMP-9 in the intensive treatment group after 2 months were significantly lower than those in the standard treatment group (3.46 ± 1.82 vs 4.52 ± 2.71 , P <0.05, 252.7 ± 164.1 vs 321.62 ± 178.46, P <0.05). There was significant difference between the two groups in end point events, and the effect of intensive treatment group was better than that of standard treatment group. In the intensive treatment group, the mortality, the incidence of recurrent myocardial infarction, the incidence of angina pectoris, and the readmission rate were lower than those in the standard treatment group. The ejection fraction in the intensive treatment group was higher than that in the standard treatment group (P <0.05). Conclusions Atorvastatin can significantly improve the short-term prognosis of patients with acute myocardial infarction. The improvement of prognosis is related to the lipid-lowering effect of statins.