早期他汀类药物治疗对急性心肌梗死患者的益处.docxVIP

早期他汀类药物治疗对急性心肌梗 死患者的益处 【摘要】 目的：探讨早期他汀类药物 治疗对急性心肌梗死患者带来的益处。 方法: 571例急性心肌梗死患者分为他汀类药物治 疗组和非他汀类药物治疗组，观察两组患者 ck和CK MB的峰值变化、发生充血性心力 衰竭的风险和院内死亡率的变化情况。 结果: 他汀类药物治疗组院内死亡率、ck和CK MB 的峰值降低，进展为CHF勺风险降低。结论： 对急性心肌梗死患者在一般治疗的基础上 早期应用他汀类药物治疗可获得很大的益 处，且安全、可靠。 【关键词】 他汀类药物；急性心肌梗死； 低充血性心力衰竭 Benefits of Very Early Administration of Statins during the First Day of Hospitalization in Patients with Acute Myocardial Infarction-A Abstract : Objective To investigate the benefits of very early statin therapy in patients with acute myocardial infarction . Methods We identified 571 consecutive patients with AMI from 1998 to 2006 divided them into early statin therapy (statins were administered within the initial 24 h of hospitalization , n=165) and non statin therapy groups (n二406) . We compared mortality risks , rates of CHF development and measures of peak CK and CK MB values between the groups , Results In hospital mortality was lower in the early statin therapy group (%) compared to the non statin therapy group (%) , P . Patients with very early statin treatment had lower peak CK(60 5ng/nil) and CK MB (41 ng/nil) values compared to non statin patients (875 ng/ml and 92 ng/ml) , P in the early statin group had lower risks of developing CHF during hospitalization (%) compared to the non statin group (%) , P Based on the traditional therapy,AMI can obtain many benefits from very early administration of statin therapy during the first day of hospitalization . It is an effective and safe method. Key words : Statins ; Acute myocardial infarction;CHF 急性心肌梗死发病初期死亡率较高， 治 疗的关键是尽早给予冠脉血运重建治疗， 使 闭塞的冠脉再通，恢复冠脉血流和心肌的再 灌注。近年来，积极开展了溶栓、介入合并 转换酶抑制剂、6 受体阻滞剂、低分子肝 素、氯毗格雷等治疗挽救了许多患者的生命， 他汀类药物的治疗也越来越多地引起了人 们的重视，关于早期应用他汀类药物能否降 低充血性心力衰竭风险和改变死亡时间， 目 前鲜有相关报道。为此，我们做了如下研究。 1材料与方法 研究对象 入选标准1998年至2006年我院心内科 571例连续的急性心肌梗死患者，均符合WHO 关于急性心肌梗死的诊断标准 排除标准所有其他炎症性疾病和肝、 肾功能不全，入院24 h内死亡者。如果随 访期间发生其他炎症性疾病和严重肝、 肾功 能不全的病例也需剔除。 停药警戒值血清总胆固醇(TC) mmol/L; 服药期间，若出现肌痛并肌酸激酶(CK)＞正 常高限5倍，丙氨酸转氨酶(ALT) ＞正常高 限3倍，肌酊＞221 umol/L等严重副作用需 停药。 研究方法将其分为早期他汀类药物治