本文選題：急性心肌梗死 + 冠心病　； 參考：《中國醫(yī)院藥學(xué)雜志》2017年12期

【摘要】：目的:探討辛伐他汀對預(yù)防合并糖尿病的老年急性心肌梗死再發(fā)的療效并分析可能機制,以期為臨床診療提供參考。方法:分析2012年1月-2014年1月在某院通過保守治療臨床治愈的老年急性心肌梗死患者的臨床資料,所有患者均合并2型糖尿病,依據(jù)患者心肌梗死愈后治療藥物不同分為觀察組(辛伐他汀)及對照組。治療隨訪1年后分析療效及可能機制。結(jié)果:本研究共納入患者92例,其中觀察組49例,對照組43例。治療后觀察組患者TC、TG及LDL-C水平均顯著低于對照組,差異具有統(tǒng)計學(xué)意義(P0.05);而HDL-C水平顯著高于對照組(P0.05)。觀察組NO水平及FMD顯著高于對照組,而ET-1水平顯著低于對照組,差異均具有統(tǒng)計學(xué)意義(P0.05)觀察組患者CRP及IL-6水平均顯著低于對照組,差異具有統(tǒng)計學(xué)意義(P0.05)。觀察組累積1年心肌梗死再發(fā)率顯著低于對照組,差異具有統(tǒng)計學(xué)意義(8.16%,4/49 vs.25.58%,11/43;Log-rankΧ2=4.954,P=0.026)。結(jié)論:辛伐他汀可有效預(yù)防合并糖尿的老年急性心肌梗死再發(fā),可能與其調(diào)節(jié)血脂、血管功能及炎癥反應(yīng)有關(guān)。
[Abstract]:Objective: to investigate the efficacy of simvastatin in preventing recurrent acute myocardial infarction (AMI) in elderly patients with diabetes mellitus (DM) and to analyze the possible mechanism so as to provide reference for clinical diagnosis and treatment. Methods: from January 2012 to January 2014, the clinical data of elderly patients with acute myocardial infarction (AMI) cured by conservative treatment in a hospital were analyzed. All the patients were complicated with type 2 diabetes mellitus. The patients were divided into observation group (simvastatin) and control group. The therapeutic effect and possible mechanism were analyzed after 1 year follow-up. Results: 92 patients were included in this study, 49 cases in the observation group and 43 cases in the control group. After treatment, the levels of TG and LDL-C in the observation group were significantly lower than those in the control group, the difference was statistically significant (P 0.05), and the level of HDL-C was significantly higher than that in the control group (P 0.05). The levels of no and FMD in the observation group were significantly higher than those in the control group, while the level of ET-1 was significantly lower than that in the control group (P 0.05). The levels of CRP and IL-6 in the observation group were significantly lower than those in the control group (P 0.05). The recurrence rate of myocardial infarction accumulated for one year in the observation group was significantly lower than that in the control group. The difference was statistically significant. Conclusion: simvastatin can effectively prevent the recurrence of acute myocardial infarction in elderly patients with diabetes, which may be related to its regulation of blood lipids, vascular function and inflammation.
【作者單位】： 昆明醫(yī)科大學(xué)第二附屬醫(yī)院藥學(xué)部;
【分類號】：R542.22;R587.2

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