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目的探讨大剂量美托洛尔联合辛伐他汀治疗急性心肌梗死(AMI)的临床疗效。方法选取东莞市大朗医院2012年4月—2014年4月收治的急性心肌梗死患者68例,采用随机数字表法分为观察组与对照组,各34例。对照组给予大剂量美托洛尔治疗,观察组给予大剂量美托洛尔联合辛伐他汀治疗。观察两组患者临床疗效,治疗前后左心室射血分数(LVEF)、左心室舒张末期内径(LVDd)及不良心脏事件发生情况。结果观察组患者临床疗效优于对照组(Z=4.66,P<0.05)。两组患者治疗前LVEF与LVDd比较,差异无统计学意义(P>0.05),治疗后观察组患者LVEF高于对照组,LVDd低于对照组(P<0.05);两组患者治疗后LVEF分别高于治疗前,LVDd分别低于治疗前(P<0.05)。对照组患者不良心脏事件发生率为67.65%,高于观察组的41.18%(χ2=4.80,P<0.05)。结论大剂量美托洛尔联合辛伐他汀治疗AMI的临床疗效显著,可改善患者心肌功能,且安全性较高。
Objective To investigate the clinical efficacy of high-dose metoprolol combined with simvastatin in the treatment of acute myocardial infarction (AMI). Methods 68 patients with acute myocardial infarction admitted from April 2012 to April 2014 in Dalang Hospital of Dongguan City were randomly divided into observation group and control group with 34 cases in each group. The control group was given high-dose metoprolol treatment, and the observation group was given high-dose metoprolol combined with simvastatin. The clinical efficacy, LVEF, LVDd and adverse cardiac events in both groups were observed before and after treatment. Results The clinical efficacy of the observation group was better than that of the control group (Z = 4.66, P <0.05). There was no significant difference in LVEF and LVDd between the two groups before treatment (P> 0.05). After treatment, the LVEF in observation group was higher than that in control group and LVDd was lower than that in control group (P <0.05) Before treatment, LVDd was lower than before treatment (P <0.05). The incidence of adverse cardiac events in the control group was 67.65%, higher than 41.18% in the observation group (χ2 = 4.80, P <0.05). Conclusion High-dose metoprolol combined with simvastatin has significant clinical efficacy in the treatment of AMI, which can improve myocardial function in patients with high safety.