氯吡格雷联合阿托伐他汀治疗急性心肌梗死疗效及对血清同型半胱氨酸的影响

摘要

目的：观察氯吡格雷联合阿托伐他汀治疗急性心肌梗死（AMI）的疗效及对血清同型半胱氨酸的影响。方法将2012年9月至2015年6月确诊为AMI的83例患者随机分为两组，对照组41例采用常规治疗，观察组42例采用氯吡格雷联合阿托伐他汀治疗，28 d为1个疗程。比较两组患者治疗前后超敏C反应蛋白（Hs－CRP）、同型半胱氨酸（Hcy）、脑钠肽（BNP）、左室射血分数（LVEF）等指标改善情况。结果治疗后，两组患者Hs－CRP，Hcy，BNP均降低，LVEF均升高，但观察组改善更显著，总有效率更高（ P﹤0．05）；对患者持续随访1年，观察组治疗后6个月及12个月内再梗死率及死亡率均低于对照组（ P﹤0．05）。结论氯吡格雷联合阿托伐他汀治疗急性心肌梗死疗效显著，可加速疾病康复，改善预后，值得临床推广。%Objective To investigate the efficacy of clopidogrel combined with atorvastatin in the treatment of acute myocardial infarction (AMI)and its effect on serum homocysteine. Methods A total of 83 patients with AMI in the hospital from September 2012 to June 2015 were selected and randomly divided into two groups:the control group( n=41,conventional treatment)and the observation group ( n=42,clopidogrel combined with atorvastatin treatment). 28 d was 1 course of treatment. Hs-CRP,homocysteine(Hcy),BNP and left ventricular ejection fraction (LVEF) levels were measured and compared before and after treatment in the two groups. Results After treatment,the Hs-CRP,Hcy and BNP decreased and LVEF increased in the two groups,but the observation group improved more sig-nificantly,and its total effective rate was higher ( P ﹤ 0. 05);the patients were followed up for 1 year. The rate of re-infarction and mortality in the observation group was lower at 6 months and 12 months after treatment ( P ﹤ 0. 05). Conclusion Clopidogrel com-bined with atorvastatin in the treatment of acute myocardial infarction is effective,can accelerate the rehabilitation of diseases and im-prove the prognosis,which is worthy of clinical promotion.