不同剂量瑞舒伐他汀钙治疗冠状动脉慢血流的临床效果研究

摘要

Objective To evaluate the effect of different-dose rosuvastatin therapy on coronary slow flow (CSF). Methods 90 patients were enrolled in our hospital during Jan 2010 and Jan 2013, diagnosed as having coronary slow flow by coronary angiography. They were randomized into high dose rosuvastatin group ( high dose group) , low dose rosuvastatin group ( low dose group) and control group ( n=30 each) . Rosuvastatin 20 mg/d, rosuvastatin 10 mg/d and placebo were given to the first two groups and the control group was only given conventional therapy. The course of the therapy was 4 weeks and M-TFC value was used to compare the coronary blood flow among different groups. The effect rates of therapies on angina in different groups were also evaluated. Results 4 weeks after treatment, level of M-TFC in all the groups were decreased sig-nificantly. Levels of M-TFC in both high dose group and low dose group were significantly lower than that in control group, and the level in high dose group was significantly lower than that in low dose group (P<0. 01). The effect rates of high dose group and low dose group were significantly higher than that of control group (χ2 =6. 2388, P=0. 0125; χ2 =4. 8000, P=0. 0285). There was no difference in the effect rates between high dose group and low dose group (χ2 =0. 0113, P =0. 7386 ) . Conclusion For patients with coronary slow flow, rosuvastatin therapy, based on the conventional medication, can significantly improve the coronary blood flow velocity and increase the effect rate in treatment of angina. Intensive rosuvastatin therapy with 20 mg/d is more effective for the patients with coronary slow flow.%目的：评价瑞舒伐他汀钙对冠状动脉慢血流( coronary slow flow, CSF)的治疗效果及其与剂量的关系。方法选取2010年1月—2013年1月我院经冠状动脉造影确诊为CSF患者90例,随机分为高剂量瑞舒伐他汀钙组(高剂量组)、低剂量瑞舒伐他汀钙组(低剂量组)及对照组各30例,前两组在常规治疗基础上分别给予瑞舒伐他汀钙20 mg/d、10 mg/d,对照组仅予基础治疗。治疗4周后,采用心肌梗死溶栓血流帧数平均值( M-TFC)比较治疗前后各组冠状动脉血流速度；根据心绞痛发作次数改善情况,评价各组心绞痛治疗总有效率。结果治疗4周后,3组M-TFC较治疗前均明显下降,且治疗后高剂量组、低剂量组M-TFC均低于对照组,高剂量组M-TFC低于低剂量组,差异均有统计学意义(P<0．01)；高剂量组、低剂量组心绞痛改善总有效率均明显高于对照组(χ2=6.2388,P=0.0125；χ2=4．8000,P=0．0285),而高剂量组与低剂量组心绞痛改善总有效率比较差异无统计学意义(χ2=0.0113,P=0.7386)。结论在常规扩血管药物治疗基础上联用瑞舒伐他汀钙,可有效改善CSF患者冠状动脉血流速度,明显提高心绞痛治疗有效率,且瑞舒伐他汀钙20 mg/d强化治疗更有效。