不同剂量辛伐他汀治疗急性心肌梗死疗效观察

目的观察辛伐他汀对急性心肌梗死早期溶栓治疗的临床疗效。方法64例急性心肌梗死（AMI）患者随机分2组，常规剂量组（A组，n=32），较高剂量组（B组，n=32），其中常规剂量组在发病后给予辛伐他汀20mg·次^-1，1次·d^-1，较高剂量组给予辛伐他汀40mg·次^-1，1次·d^-1,持续6个月，溶栓及其他常规治疗相同。治疗前及治疗2周后测量心功能、血清高敏C反应蛋白（hs—CRP）、血脂及肝功能等指标。结果治疗2周后，2组心功能均得到改善，B组优于A组，差异有显著性（P〈0．05）。2组hs—CRP与治疗前相比均有显著下降（P〈0．05），B组hs—CRP下降更明显（P〈0．01）；2组LDL-C和TC均有下降，B组显著低于常规治疗组（P〈0．05）。结论急性心肌梗死患者早期给予辛伐他汀治疗，短期就有抗炎作用，且抗炎作用独立于调脂作用，较高剂量的辛伐他汀治疗可能获益更大。

Effect of different doses of simvastatin on 64 patients with acute myocardial infarction

Objective To observe the effect of thrombolysis and simvastatin on patients with,acute myocardial infarction. Methods A total of 64 patients with acute myocardial infarction was randomly divided into 2 groups： a routine dose （20 mg） group （group A, n=32） and a high dose （40mg） group （group B, n=32）. Simvastatin was used once a day and lasted 6 mon in group A and B, respectively. Thrombolysis and other routine treatments were the same in the 2 groups. Heart function, hs-CRP, lipids, and hepatic function were measured before the treatment and 2 weeks after the treatment. Results Heart function improved and hs-CRP decreased in the 2 groups, but both in group B had significant difference （P〈0.05, P〈0. 01）. LDL-C and TC in group B were significantly lower than group A （P〈0. 05）. Conclusion Simvastatin has an anti-inflammatory effect on early acute myocardial infarction, independent of adjusting lipids. High dose of simvastatin may have more benefits.