阿托伐他汀联合阿替普酶治疗急性心肌梗死的疗效观察

目的观察阿托伐他汀联合阿替普酶治疗急性心肌梗死的治疗效果。方法选取2015年9月—2016年9月重庆市合川区中西医结合医院收治的急性心肌梗死患者86例,随机分为对照组和治疗组,每组各43例。对照组静脉注射注射用阿替普酶,120 mg/d,180 min内注射完毕。治疗组在对照组治疗基础上口服阿托伐他汀钙片,1片/次,2次/d。两组患者均连续治疗15 d。观察两组的临床疗效,同时比较两组治疗前后心率、心输出量、左心室射血分数的变化情况。观察两组病死率、休克发生率、再梗发生率及不良反应发生率。结果治疗后,对照组和治疗组的总有效率分别为74.42%、95.35%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者的心率明显降低,心输出量、左心室射血分数明显升高,同组治疗前后比较差异有统计学意义(P0.05);治疗后,治疗组患者的心率低于对照组,心输出量和左心室射血分数高于对照组,两组比较差异具有统计学意义(P0.05)。治疗组患者病死率、休克发生率、再梗发生率、不良反应发生率均明显低于对照组,两组比较差异具有统计学意义(P0.05)。结论阿托伐他汀联合阿替普酶治疗急性心肌梗死具有较好的临床疗效,可明显改善患者的心功能相关指标,同时可改善患者预后,具有一定的临床推广应用价值。

Clinical observation on atorvastatin combined with alteplase in treatment of acute myocardial infarction

Objective To explore the curative effect of atorvastatin combined with alteplase in treatment of acute myocardial infarction. Methods Patients (86 cases) with acute myocardial infarction in Hechuan District Hospitals of Traditional Chinese and Western Medicine in Chongqing from September 2015 to September 2016 were randomly divided into control (43 cases) and treatment (43 cases) groups. Patients in the control group were iv administered with Alteplase for injection in 180 min, 120 mg/d. Patients in the treatment group were po administered with Atorvastatin Calcium Tablets on the basis of the control group, 1 tablet/time, twice daily. Patients in two groups were treated for 15 d. After treatment, the clinical efficacy was evaluated, and the changes of heart rate, cardiac output, and left ventricular ejection fraction in two groups before and after treatment were compared. The fatality rate, shock incidence, reterrier incidence, and adverse reactions incidence were observed. Results After treatment, the clinical efficacy in the control and treatment groups were 74.42% and 95.35%, respectively, and there was difference between two groups (P < 0.05). After treatment, the heart rate in two groups significantly decreased, but cardiac output and left ventricular ejection fraction obviously increased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the heart rate in the treatment group was lower than that in the control group, and cardiac output and left ventricular ejection fraction were higher than those in the control group, and there was difference between two groups (P < 0.05). The fatality rate, shock incidence, reterrier incidence, and adverse reactions incidence were significantly lower than those in the control group, and there was difference between two groups (P < 0.05). Conclusion Atorvastatin combined with alteplase has good clinical effect in treatment of acute myocardial infarction, and can obviously improve the cardiac function related indicators and can improve the prognosis of patients, which has a certain clinical application value.