阿托伐他汀联合替罗非班在急性心肌梗死治疗中的应用

目的:探讨阿托伐他汀联合替罗非班在未接受溶栓或急诊冠状动脉介入治疗(PCI)的急性心肌梗死(AMI)患者中应用的安全性及有效性。方法:将未接受溶栓或急诊PCI治疗的AMI患者随机分为对照组(A组)、阿托伐他汀组(B组)、替罗非班组(C组)和阿托伐他汀联合B组(D组)。观察各组患者出院时:(1)住院期间心血管事件的发生率。(2)冠状动脉造影示罪犯血管的再通率。(3)PCI术后1月内急性亚急性支架内血栓形成率。(4)住院两周后超声心动图测定左心功能受损率。(5)出血并发症的发生率。结果:D组患者住院期间的心血管事件发生率明显低于B组、C组和A组(P<0.005);D组患者罪犯血管的再通率明显高于B组、C组和A组(P<0.005);C组和D组PCI术后的急性亚急性血栓形成率明显低于A组(P<0.05)。B组、C组和D组住院两周后的左心功能受损率低于A组,但无统计学意义(P>0.05)。B组、C组和D组与A组的出血发生率无明显差异(P>0.05)。结论:阿托伐他汀联合替罗非班在AMI患者的治疗中安全、有效,对未行溶栓或急诊PCI治疗的AMI患者有较大的应用价值。

TheApplication ofAtorvastatin Combined Tirofiban in Patients withAcute Myocardial Infarction

Objective:Study on the safety and efficacy of atorvastatin combined tirofiban in patients with acute myocardial infarction(AMI) did not undergo thrombolytic therapy or primary percutaneous coronary intervention(PCI).Methods:The patients with AMI did not undergo thrombolytic therapy or emergency PCI were randomly allocated into control group(A group),atorvastatin group(B group),tirofiban group(C group) and atorvastatin combined tirofiban group(D group).Observation the indicators when they discharged(1) Cardiovascular events incidence in hospital(recurrent angina,severe heart failure,death).(2) Recanalization rate of criminal showed by coronary angiography.(3) Acute or subacute stent thrombosis rate one month after PCI.(4) Left ventricular dysfunction rate measured by echocardiographic two weeks after hospitalization.(5) Bleeding rate.Results:Cardiovascular events during hospitalization of D group was significantly lower than the B group,C group and A group(P<0.005);Recanalization rate of criminals in D group was significantly higher than B group,C group and A group(P<0.005);Acute or subacute stent thrombosis rate after PCI of D group was significantly lower than the A group(P<0.05).Left ventricular dysfunction rate two weeks after hospitalization of B group,tirofiban and D group was lower than the A group,but no significant difference(P> 0.05).Bleeding rate was not significant difference among B group,C group,atorvastatin combined tirofiban and the A group(P>0.05).Conclusion:Atorvastatin combined tirofiban is safe and effective for the patients with acute myocardial infarction,the method have greater value in the patients with acute myocardial infarction did not undergo thrombolytic therapy or primary PCI.