辛伐他汀联合低分子肝素治疗急性心肌梗死的临床观察
Clinical observation of treatment of acute myocardial infarction by simvastatin with low molecular weight heparin
目的 观察辛伐他汀联用低分子肝素钠治疗急性心肌梗死的临床疗效和安全性.方法 80例急性心肌梗死患者随机分为辛伐他汀联用低分子肝素钠治疗(联合组)40例,硝酸酯类药治疗(常规组)40例,观察治疗前后血清炎性因子水平、动态心电图及疗效指标.结果 常规组、联合组治疗后TC、TG、LDL、HDL-C、高敏C反应蛋白(hs-CRPs)、可溶性白细胞分化抗原40配体(sCD40L)水平均较治疗前下降(t=2.131,t=2.211,t=2.235,t=2.211,t=2.115,t=2.274,均P<0.05);联合组治疗后hs-CRP、sCD40L下降水平较常规组明显(t=2.231,t=2.245,均P<0.05);常规组IMT下降1.1%低于联合组3.4%(X2=4.01,P<0.05);常规组治疗后斑块积分11.5%高于联合组斑块积分下降16.9%(X2=4.25,P<0.05);联合组治疗后软斑数(7.7%)低于治疗前(28.2%)(X2=6.78,P<0.01);联合组治疗后EDV、ESV、EF较治疗前下降明显(t=2.221,t=2.342,t=2.245,P<0.05);常规组和联合组治疗后缺血发作次数、ST段最大下降幅度、ST段下降时间明显低于治疗前(t=2.731,t=2.781,t=2.785,t=2.781,t=2.815,t=2.874,均P<0.01);联合组总有效率90.0%高于常规组67.4%(X2=4.25,P<0.05).结论 辛伐他汀联用低分子肝素钠治疗急性心肌梗死疗效较好.
更多Objective To observe the clinical effect and side-effect of low molecular weight beparin (LMWH) and simvastatin on patients with acute myocardial infarction(AMI). Methods 80 cases of AMI were randomly divided into simvastatin with low-molecular-weight heparin treatment (joint group) 40 cases and nitrates drug treatment( conventional group) 40 cases Au the patiants were observed before and after treatment for serum inflammatory factor,quantitative gated tomography,Holter and analysis of the effectbefore and after treatment. Results The conventional group and joint group after the treatment of TC, TG, LDL, HDL-C, hs-CRPs, CD40L levels were decreased than before treatment (t=2. 131, t = 2. 211, t = 2. 235, t = 2. 211, t = 2. 115, t = 2. 274, both P<0. 05 ) ; the joint group after treatment bs-CRP, sCD40L significantly declined than conventional group (t = 2. 231, t = 2. 245, both P<0. 05 ) ;conventional group of IMT dropped 1.1% lower than the 3.4% of the joint group ( X2 = 4. 01,P<0. 05 ) ; conventional treatment group plaque score 11.5% higher than the combined group plaque score decreased 16. 9% (X2 =4. 25 ,P<0. 05) ;joint group after treatment,a few soft spots(7. 7 %) lower than before treatment(28.2%) (X2 = 6. 78,P<0. 01) ;the joint group of EDV,ESV,EF after treatment decreased significantly than before treatment (t =2. 221 ,t =2. 342 ,t = 2. 245, P<0. 05) ; conventional treatment group and joint group after the number of ischemic attack, ST above the largest decrease, ST segment depression was significantly lower than the time before treatment(t=2. 731 ,t=2. 781, t=2. 785,t=2. 781, t=2. 815, t=2. 874, both P<0. 01);joint total effective rate 90. 0% higher than the conventional group 67.4% (X2=4. 25,P<0. 05 ). Conclusion Simvastatin combined with LMWH have good effect in the treatment of acute myocardial infarction.
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