阿托伐他汀对心肌梗死患者的保护作用及其机制研究

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目的:观察阿托伐他汀对心肌梗死患者的保护作用并探讨其可能的机制。方法:抽取我院2013年3月~2015年3月收治的急性心肌梗死(AMI)患者78例(标记为观察组)及行健康体检人员50例(标记为对照组)。采用随机双盲法将观察组患者分为常规组与治疗组各39例,常规组采取常规治疗,治疗组在常规组基础上加以阿托伐他汀口服,20 mg/次,治疗28 d,比较两组患者治疗前后血清炎症因子和血脂水平、心功能及不良事件的发生情况。结果:治疗前,观察组患者的血清IL-6、IL-8、CRP水平均明显高于对照组,差异有统计学意义(P<0.05)。治疗后,治疗组血清IL-6、IL-8、CRP、TC、TG、LDL-C水平均明显低于常规组,LVEF、CO水平明显高于常规组,差异均有统计学意义(P<0.05)。治疗28d,治疗组心律失常的发生率、死亡率分别为12.8%、2.6%,均显著低于常规组的38.5%、17.9%(P<0.05)。结论:阿托伐他汀可有效改善急性心肌梗死患者的心功能,减少不良心血管事件,这可能与其降低血清IL-6、IL-8、CRP及血脂水平有关。 Objective: To observe the protective effect of atorvastatin on patients with myocardial infarction and to explore its possible mechanism. Methods: 78 patients (marked as observation group) and 50 health examination staff (marked as control group) of acute myocardial infarction (AMI) admitted to our hospital from March 2013 to March 2015 were enrolled. The patients in observation group were divided into routine group and treatment group with 39 cases in randomized double-blind method. The routine group was given routine treatment. The treatment group was treated with atorvastatin orally 20 mg once daily for 28 days. Serum inflammatory factors and blood lipid levels, cardiac function and adverse events in both groups before and after treatment. Results: Before treatment, the levels of serum IL-6, IL-8 and CRP in the observation group were significantly higher than those in the control group (P <0.05). After treatment, the serum levels of IL-6, IL-8, CRP, TC, TG and LDL-C in the treatment group were significantly lower than those in the conventional group, and the levels of LVEF and CO in the treatment group were significantly higher than those in the conventional group (P < 0.05). After 28 days of treatment, the incidence of arrhythmia and mortality in the treatment group were 12.8% and 2.6%, respectively, which were significantly lower than those in the conventional group (38.5% and 17.9%, P <0.05). Conclusion: Atorvastatin can improve cardiac function and reduce adverse cardiovascular events in patients with acute myocardial infarction, which may be related to the reduction of serum IL-6, IL-8, CRP and blood lipid level.
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