内科

目的观察阿托伐他汀联合依折麦布治疗早发冠心病急性心肌梗死的疗效及其安全性。方法选择早发冠心病急性心肌梗死患者48例，随机分为两组，每组24例，对照组给予阿托伐他汀治疗，20 mg/d，观察组于对照组治疗的基础上给予依折麦布治疗，10 mg/d，比较两组患者疗效及血脂指标、超敏C-反应蛋白（hs-CRP）、左室射血分数（LVEE）及内皮舒张功能（FMD）的变化。结果两组均无死亡病例，观察组患者复发性心绞痛1例；对照组血运重建3例，复发性心绞痛2例。观察组患者TC、TG、LDL-C水平分别为（3.2±0.3）mmol/L、（1.8±0.1）mmol/L、（2.0±0.2）mmol/L，均显著低于对照组（P＜0.05）。观察组HDL-C水平为（1.5±0.2）mmol/L，显著高于对照组（P＜0.05）。治疗后观察组患者hs-CRP水平为（1.9±0.3）mg/L，显著低于对照组（P＜0.05）；观察组患者LVEE及FMD水平均高于对照组（P＜0.05）。两组患者不良反应发生率比较差异无统计学意义（P＞0.05）。结论阿托伐他汀联合依折麦布应用于早发冠心病急性心肌梗死患者疗效较佳，血清总胆固醇、低密度脂蛋白胆固醇水平显著降低，且应用较为安全，具有临床推广价值。

ObjectiveTo observe the effect and safety of atorvastatin combined with ezetimibe for treatment of patients with early acute myocardial. Methods48 patients with early acute myocardial were randomly divided into two groups with 24 cases in each, the control group was given atorvastatin, 20 mg/d,while the observation group was given ezetimibe(10 mg/d )based on the control group, the curative effect, blood lipids, hs-CRP,LVEE and FMD were compared between the two groups after treatemt. ResultsThere was no death cases in the two groups ,the patients ofrecurrent angina pectoris of the two groups were 1 and 2 cases, respectively, 3 patients were revascularization in control group. The levels of TC, TG, LDL-C, hs-CRP in theobservation group were (3.2±0.3) mmol/L, (1.8±0.1) mmol/L, (2±0.2) mmol/L, (1.9±0.3) mg/L, respectively and which were significantly lower than those in the control group,(P＜0.05). The level of HDL-C was (1.5±0.2) mmol/L in observation group which was significantly higher than that in control group (P＜0.05); the levels of LVEE and FMD in observation group were higher than that in the control group(P＜0.05). The incidence rate of adverse reactions between the two groups had no significant difference(P＞0.05). ConclusionsAtorvastatin combined with ezetimibe can lower the level of serum total cholesterol and density lipoprotein cholesterol,which is useful and safe for treatment of patients with early acute myocardial,and worthy of popularization and application.