瑞舒伐他汀与阿托伐他汀在急性冠状动脉综合征患者PCI围手术期中的应用效果比较

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目的比较国产瑞舒伐他汀与阿托伐他汀对急性冠状动脉综合征(ACS)患者冠状动脉介入术(PCI)围手术期的疗效及安全性。方法选择2014年2月至2015年3月于我院心内科住院行PCI治疗的ACS患者160例,按数表法随机分为瑞舒伐他汀组和阿托伐他汀组,每组80例,两组患者入院即分别给予瑞舒伐他汀和阿托伐他汀20 mg口服,并以20 mg/d维持治疗至PCI术后1个月。观察两组患者治疗前后血脂变化、主要不良心血管事件(MACE)、心肌损伤及药物不良反应的发生情况。结果治疗后两组患者的低密度脂蛋白胆固醇(LDL-C)均较治疗前明显下降,而高密度脂蛋白胆固醇(HDL-C)均有所上升,且瑞舒伐他汀组优于阿托伐他汀组,差异均有统计学意义(P<0.05);瑞舒伐他汀组和阿托伐他汀组患者术后MACE、心肌损伤、药物不良反应的发生率分别为11.3%(9/80)、12.5%(10/80)、6.3%(5/80)和25.0%(20/80)、26.3%(21/80)、7.5%(6/80),瑞舒伐他汀组患者的MACE和心肌损伤发生率均低于阿托伐他汀组,差异均有统计学意义(P<0.05)。结论国产瑞舒伐他汀对ACS患者PCI围手术期的疗效明显优于阿托伐他汀,其能有效改善患者血脂及近期预后,值得临床推广应用。 Objective To compare the efficacy and safety of domestic rosuvastatin and atorvastatin on patients undergoing percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS). Methods From February 2014 to March 2015 in our hospital cardiology department of PCI in patients with ACS treated 160 cases of ACS, according to the table method were randomly divided into rosuvastatin group and atorvastatin group, 80 cases in each group, Both groups were given rosuvastatin and atorvastatin 20 mg orally on admission, and were maintained at 20 mg / d until 1 month after PCI. The changes of blood lipid, major adverse cardiovascular events (MACE), myocardial injury and adverse drug reactions were observed before and after treatment in both groups. Results After treatment, the levels of LDL-C in both groups were significantly lower than those before treatment, while the levels of high-density lipoprotein cholesterol (HDL-C) increased, and rosuvastatin group was better than atropine (P <0.05). The incidences of postoperative MACE, myocardial injury and adverse drug reactions in rosuvastatin group and atorvastatin group were 11.3% (9/80) , 12.5% ​​(10/80), 6.3% (5/80), 25.0% (20/80), 26.3% (21/80) and 7.5% (6/80) The incidence of myocardial injury was lower than that of atorvastatin group, with statistical significance (P <0.05). Conclusion domestic rosuvastatin on ACS patients with perioperative efficacy of PCI was significantly better than atorvastatin, which can effectively improve the patient’s blood lipids and short-term prognosis, worthy of clinical application.
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