【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。更多还原

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