早期静脉溶栓联合阿托伐他汀对急性心肌梗死的干预效果

目的 观察早期静脉溶栓联合阿托伐他汀治疗急性心肌梗死的临床疗效.方法 选取201 1年3月至2012年3月收治的急性心肌梗死患者72例作为研究对象.采用随机数字表法分为试验组和对照组,每组36例,试验组给予早期静脉溶栓联合阿托伐他汀治疗,对照组给予阿托伐他汀治疗.观察两组治疗效果.结果 试验组血管再通率明显高于对照组80.6％（29/36）比52.8％（19/36）],梗死后心绞痛、心力衰竭以及再灌注心律失常的发生率明显低于对照组11.1％（4/36）比27.8％ （10/36）,8.3％ （3/36）比25.0％（9/36）,44.4％ （16/36）比72.2％（26/36）],差异均有统计学意义（P＜0.05）.两组患者治疗前白细胞配体分化抗原、基质金属蛋白酶9以及C反应蛋白比较差异无统计学意义（P＞0.05）,治疗后均较治疗前明显改善,且试验组改善情况优于对照组,差异有统计学意义（P＜0.05）.试验组与对照组治疗前美国国立卫生研究院卒中量表（NIHSS）评分比较差异无统计学意义（P＞0.05）,试验组治疗后NIHSS评分显著优于对照组（4.2±3.7）分比（7.9±4.1）分],差异有统计学意义（P＜0.05）.试验组治疗后3个月改良Rankin量表（mRS）评分0～1分比例明显高于对照组52.8％（19/36）比33.3％（12/36）],2～6分比例明显低于对照组47.2％（17/36）比66.7％（24/36）],差异均有统计学意义（P＜0.05）.结论 早期静脉溶栓联合阿托伐他汀治疗急性心肌梗死疗效显著,具有一定的临床应用价值.

The effect of early intravenous thrombolysis combined with atorvastatin in the treatment of acute myocardial infarction

Objective To observe the clinical curative effect of early intravenous thrombolysis combined with atorvastatin in the treatment of acute myocardial infarction.Methods Seventy-two patients with acute myocardial infarction from March 2011 to March 2012 were divided into experimental group and control group by random number table method,with 36 cases in each.Experimental group was given early intravenous thrombolysis combined with atorvastatin treatment,and control group was given atorvastatin treatment.The effects in 2 groups was observed.Results The recanalization rate in experimental group was significantly higher than that in control group 80.6% （29/36） vs.52.8% （19/36）],and the incidence of post infarction angina,heart failure and reperfusion arrhythmia were significantly lower than those in control group 11.1%（4/36） vs.27.8%（10/36）,8.3%（3/36） vs.25.0%（9/36）,44.4%（16/36） vs.72.2%（26/36）],there were significant differences（P〈 0.05）.The leukocyte differentiation antigen,matrix metalloproteinases and C reactive protein between 2 groups before treatment had no significant difference （P 〉 0.05）,but those indexes after treatment were obviously improved,the improvement in experimental group was better than that in control group,there was significant difference （P 〈0.05）.The United States National Institutes of Health Stroke Scale （NIHSS） score between 2 groups before treatment had no significant difference （P 〉 0.05）,the NIHSS score after treatment in experimental group was better than that in control group （4.2 ± 3.7） scores vs.（7.9 ± 4.1） scores] （P 〈 0.05）.The proportion of mRS score 0-1 after 3 months of treatment in experimental group was higher than that in control group 52.8%（19/36） vs.33.3%（12/36）],the proportion of 2-6 scores was lower than that in control group 47.2% （17/36） vs.66.7% （24/36）] （P 〈0.05）.Conclusion Early intravenous thrombolysis combined with atorvastatin has obviously curative effect in the treatment of acute myocardial infarction and has some clinical value.