辛伐他汀对急性心肌梗死合并房颤患者的临床疗效分析

目的：观察辛伐他汀对急性心肌梗死合并阵发性房颤患者血脂、房颤再发率和缺血事件发生的影响。方法：86例急性心肌梗死合并阵发性房颤患者分为两组：治疗组41例,常规治疗同时,口服辛伐他汀剂量20mg/d;对照组45例,仅给予常规治疗。追踪18个月,观察血脂、阵发性房颤再发率和转为持续性或永久性房颤的发生率,以及缺血性相关事件的发生情况。结果：（1）对照组治疗前后血脂无显著性变化（P〉0.05）;治疗组治疗前后总胆固醇和低密度胆固醇显著下降（P〈0.05）。（2）阵发性房颤再发率和转为持续性或永久性房颤的发生率：治疗组阵发性房颤再次发作4例（9.6%）,明显低于对照组6例（13.3%,P〈0.05）;转为持续性或永久性房颤2例（4.9%）;明显低于对照组13例（28.9%,P〈0.05）。（3）缺血性事件的发生率：治疗组发生缺血性事件8例（19.5%）,其中心力衰竭3例（7.3%）,冠心病恶化再入院2例（4.9%）,心源性死亡2例（4.9%）,脑卒中1例（2.4%）,明显低于对照组20例（44.4%,P〈0.05）。结论：急性心肌梗死合并心房颤动的患者应用辛伐他汀治疗,不仅能降低血清总胆固醇和低密度胆固醇,而且能降低阵发性房颤的再发率,降低持续性或永久性房颤的发生率,减少缺血事件的发生。

Analysis of the clinical effect of simvastatin in acute myocardial infarction with paroxysmal atrial fibrillation

Objective:To investigate the effect of simvastation on the blood lipid,the recurrence rate of atrial fibrillation and the occurrence of ischemia event in patients with acute myocardial infarction and paroxysmal atrial fibrillation.Methods:86 patients with acute myocardial infarction and paroxysmal atrial fibrillation were divided into the treatment group(41 cases)and control group(45 cases).The routine therapy was used in both groups,besides this,the treatment group was added with simvastatin 20 mg once every night orally.All the patients were followed up 18 months for observing the changes of blood lipid and cardiac function,the recurrence rate of atrial fibrillation,the incidence rate of continuous or permanent atrial fibrillation and occurence of ischemia event.Results:(1)The outcome showed that the levels of serum TC and LDL-C in the treatment group decreased evidently after treatment compared with those before treatment(P<0.05).(2)The recurrence rate of paroxysmal atrial fibrillation in the treatment group was 9.6%,significantly lower than 13.3% in the control group(P<0.05).Additionally,the incidence rate of continuous or permanent atrial fibrillation in the treatment group was 4.9%,significantly lower than 28.9% in the control group(P<0.05).(3)The incidence rate of ischemia event of coronary in the treatment group was 19.5%,evidently lower than 44.4% in the control group(P<0.05).Conclusion:Using simvastatin in treating acute myocardial infarction with paroxysmal atrial fibrillation not only could decrease the levels of serum TC and LDL-C,but also decrease the recurrence rate of paroxysmal atrial fibrillation and the incidence rate of continuous or permanent atrial fibrillation,and reduce the occurrence of ischemia event.