摘要
目的通过对冠心病急性冠脉综合征(ACS)患者在常规治疗的基础上加用不同剂量的阿托伐他汀治疗,以探讨阿托伐他汀在ACS患者二级预防中的作用;揭示阿托伐他汀对ACS患者机体影响的差异性,为他汀的临床应用提供依据,指导临床用药。方法选取80例住院的ACS患者为研究对象,其中不稳定性心绞痛(UAP组)和急性心肌梗死(AMI组)患者各40例,每组分别给予常规治疗(A组,20例,阿托伐他汀钙10mg/d,)与强化治疗(B组,20例,阿托伐他汀钙40mg/d)。另选择同期20例行冠状动脉造影术(CAG)正常者作基础对照组。分别监测两组治疗前及治疗3个月结束时的血脂水平、氧化应激指标(ox-LDL)、炎性因子(hs-CRP)的变化。临床随访6个月,观察主要心脏不良事件(MACE)在各组患者中的发生情况及其不良反应。结果治疗前AMI组血浆ox-LDL、hs-CRP水平高于UAP组、正常对照组;UAP组ox-LDL、hs-CRP高于正常对照组;治疗后:(1)强化他汀治疗组与常规治疗组血浆ox-LDL、hs-CRP水平均较治疗前降低(;2)强化治疗组血浆ox-LDL、hs-CRP水平较常规治疗降低更明显。结论阿托伐他汀可降低血脂、ox-LDL及hs-CRP水平,强化治疗ACS的疗效优于常规剂量,且是安全的。
Objective To investigate the effect of statins intensive treatment in the secondary prevention of acute coronary syndrome（ACS）,by observing the variation of the serum concentrations of lipoprotein, ox-LDL and hs-CRP of the ACS patients who were treated with conventional therapy and intensive therapy; To explore the difference of statins between unstable angina pectoris（UA） and acute myocardial infarction（AMl）; and supply foundations on the clinical application of statins Methods 80 ACS patients were randomLy divided into conventional group（A group） ,which treated with conventional therapy with Atorvastain, and intensive group（B group）, which treated with conventional therapy. 20 objects who were normality in coronary arteriography were enrolled in Control group. The serum concentrations of lipoprotein, ox-LDL and hs-CRP were determined before and 3 months after therapy, Major adverse cardiac events（MACE） were observed in 6-month follow-up .Results （1）The serum concentrations of lipoprotein, ox-LDL and hs-CRP were were higher in patients with AMI than those in patients with UAP and control group. And AMI group more higer than UAP group in Prior-treatment. （2）The level of plasma ox-LDL, hs-CRP of conventional therapy group and Atorvastatin intensive treatment group are both obviously lower than therapy.but intensive treatment group is obviously higher than conventional therapy. Conclusion Atorvastain can decrease the serum concentrations of lipoprotein, ox-LDL and hs-CRPThe curative effect of statins intensive treatment is better than routine methodlt is safe to treat the patients with ACS of Atorvastain intensive treatment.
出处
《当代医学》
2012年第36期124-126,共3页
Contemporary Medicine
