熊敏 　王玲 　陈烈俊

【摘要】 目的：探討不同剂量瑞舒伐他汀治疗早发冠心病急性心肌梗死患者的临床效果。方法：选择2017年1-12月笔者所在医院收治的早发冠心病急性心肌梗死患者86例，将其随机分为低剂量组（10 mg/d）与高剂量组（20 mg/d），每组43例。低剂量组在常规治疗基础上给予瑞舒伐他汀钙片10 mg/d，高剂量组在常规治疗基础上给予瑞舒伐他汀钙片20 mg/d，两组均连续治疗6个月。比较两组临床效果。结果：治疗后，高剂量组患者TC及LDL-C水平降低程度高于低剂量组，HDL-C水平升高程度高于低剂量组，差异均有统计学意义（P<0.05）。治疗后，高剂量组患者FMD水平升高程度高于低剂量组，差异有统计学意义（P<0.05）。治疗后，高剂量组患者TNF-ɑ、IL-6、hs-CRP水平均明显低于低剂量组，差异有统计学意义（P<0.05）。高剂量组不良反应发生率为13.95%，心血管不良事件发生率为16.28%;低剂量组不良反应发生率为11.63%，心血管不良事件发生率为13.95%，两组比较差异均无统计学意义（字2=1.435、1.371，P>0.05）。结论：大剂量瑞舒伐他汀治疗早发冠心病急性心肌梗死具有更好的降脂、改善心功能及控制炎症的功效，且未明显增加不良反应。

【关键词】 瑞舒伐他汀 剂量 早发冠心病 急性心肌梗死 临床效果

doi：10.14033/j.cnki.cfmr.2019.28.018 文献标识码 B 文章编号 1674-6805（2019）28-00-03

Effects of Different Doses of Rosuvastatin in the Treatment of Premature Coronary Artery Disease Complicated with Acute Myocardial Infarction/XIONG Min， WANG Ling， CHEN Liejun. //Chinese and Foreign Medical Research， 2019， 17（28）： -46

[Abstract] Objective： To investigate the clinical effect of different doses of Rosuvastatin in the treatment of premature coronary artery disease complicated with acute myocardial infarction. Method： A total of 86 patients with premature coronary artery disease complicated with acute myocardial infarction admitted in our hospital form January to December 2017 were selected and randomly divided into the low dose group （10 mg/d） and the high dose group （20 mg/d）， with 43 patients in each group. The low dose group was given Rosuvastatin Calcium Tablets 10 mg/d on the basis of the routine treatment， while the high dose group was given Rosuvastatin Calcium Tablets 20 mg/d on the basis of the routine treatment. Both groups were treated continuously for 6 months. The clinical effects of the two groups were compared. Result： After treatment， the TC and LDL-C levels in the high dose group decreased more than those in the low dose group， and HDL-C levels increased more than those in the low dose group， the differences were statistically significant （P<0.05）. After treatment， the increase of FMD level in high dose group was higher than that in the low dose group， the difference was statistically significant （P<0.05）. After treatment the TNF-ɑ， IL-6， hs-CRP levels of the high dose group were significantly lower than those in the low dose group， the differences were statistically significant （P<0.05）. The incidence of adverse reactions in the high dose group was 13.95%， and the incidence of cardiovascular adverse events was 16.28%. The incidence of adverse reactions in the low dose group was 11.63%， and the incidence of cardiovascular adverse events was 13.95%. There were no significant differences between the two groups （字2=1.435， 1.371， P>0.05）. Conclusion： Large dose of Rosuvastatin in the treatment of premature coronary artery disease complicated with acute myocardial infarction has better efficacy in reducing lipid， improving cardiac function and controlling inflammation， and the adverse reactions is not significantly increased.

[Key words] Rosuvastatin Dose Premature coronary artery disease Acute myocardial infarction Clinical effect

First-authors address：Fang County Peoples Hospital， Fang County 442100， China

冠心病是臨床上最为常见的心血管疾病，早发冠心病患者发生急性心肌梗死可能性较大，其病情往往进展迅速，严重危及患者生命安全。临床研究发现，对早发冠心病患者及时进行药物治疗、培养良好的生活习惯及积极健康宣教等措施可有效避免心血管不良事件的发生[1]。他汀类药物在降脂、抗炎、保护心功能及抗血栓形成方面具有较好的效果，且早期应用他汀类药物治疗具有明显的控制炎症、调节血管内皮功能及稳定粥样硬化斑块的效果。瑞舒伐他汀钙片是临床上较为常用的他汀类药物之一，目前国内外关于不同剂量瑞舒伐他汀对早发冠心病急性心肌梗死患者的影响却少有报道[2]。……