摘要
目的 观察不同剂量瑞舒伐他汀治疗急性冠脉综合征(ACS)患者的安全性、疗效和预后。方法 选取急性冠脉综合征患者共94例,随机分为三组。其中对照组30例,给予辛伐他汀20mg/d口服;A组30例,给予瑞舒伐他汀10mg/d口服;B组34例,给予瑞舒伐他汀20mg/d口服。三组患者分别于入院时、治疗4周及治疗1年检测低密度脂蛋白胆固醇(LDL-C)、心肌酶(CK-MB)、肝功(ALT)、空腹血糖、C-反应蛋白(CRP)、TNF-α、颈动脉内膜中层厚度(IMT)等指标,随访1年,比较三组心血管事件发生率(MACE)。结果 ①治疗后,三组患者LDL、IMT、CRP和TNF-α水平均较治疗前明显下降,差异具有统计学意义(P<0.05)。三组在治疗后相同时间点比较LDL变化差异有统计学意义(P<0.05),其中B组LDL水平下降最明显。对照组和A组治疗后相同时间点的IMT、CRP和TNF-α均高于B组,差异有统计学意义(P<0.05)。②第4周时,三组间比较CK-MB变化差异有统计学意义(P<0.05),其中B组患者血清CK-MB水平下降最明显。1年时,三组间比较CK-MB水平差异无统计学意义(P>0.05)。三组在治疗后相同时间点组间比较ALT变化差异无统计学意义(P>0.05)。③三组患者治疗后空腹血糖水平均有所升高,但无论组内还是同时期组间比较差异均无统计学意义(P>0.05)。④随访1年后,对照组和A组的心血管事件发生率均高于B组,差异有统计学意义(P<0.05)。结论 大剂量瑞舒伐他汀治疗急性冠脉综合征具有更加理想的疗效,其安全性与低剂量组相比无明显差异。
Objective To investigate the safety, efficacy and prognosis of different doses of rosuvastatin in patients with acute coronary syndrome. Methods Ninety-four patients with acute coronary syndrome were enrolled and randomly divided into three groups. 30 cases in the control group were administrated with simvastatin 20mg/d, and 30 cases in the group A were administrated with rosuvastatin 10mg/d, and 34 cases in the group B were administrated with rosuvastatin 20mg/d. Each group was evaluated the levels of low density lipoprotein cholesterol (LDL-C), cardiac enzyme (CK-MB), liver function (ALT), fasting blood glucose, C-reactive protein (CRP), TNF-α, carotid intima-media thickness (IMT) at the time of initial administration, 4 weeks and 1 year after treatment. The incidence of cardiovascular events was observed after 1 year. Results ①After the treatment, the levels of LDL, IMT, CRP and TNF-α in three groups were significantly lower than those before treatment, the difference was statistically significant (P<0.05). There was significant difference in LDL among three groups at the same time after treatment (P<0.05), and the level of LDL in group B was the lowest. The level of IMT, CRP and TNF-α in control group and group A were higher than group B at the same time after treatment, the difference was statistically significant (P<0.05).②After four weeks there were significant differences in CK-MB among the three groups (P<0.05), in which the serum CK-MB level in group B decreased most obviously. After 1 year, there was no significant difference in the level of CK-MB among the three groups (P>0.05). Among the three groups, there was no significant difference in the level of ALT at the same time after treatme(ntP>0.05).③The level of fasting blood sugar in three groups was increased after treatment, but there was no significant difference.④After 1 year follow-up, the incidence of cardiovascular events in control group and group A were higher than that in group B, the difference was statistically significant (P<0.
作者
赵晓雪
王宝江
王晶
唐亮
Zhao Xiaoxue;Wang Baojiang;Wang Jing(Affiliated Central Hospital of Shenyang Medical College, Shenyang 110001)
出处
《中国现代医药杂志》
2019年第8期15-19,共5页
Modern Medicine Journal of China
基金
沈阳医学院科技基金项目(编号:20141027)
关键词
急性冠脉综合征
瑞舒伐他汀
血脂
炎性因子
颈动脉内膜中层厚度
Acute coronary syndrome
Rosuvastatin
Blood lipid
Inflammatory cytokines
Carotid intima-media thickness