急性冠脉综合征患者早期强化调脂治疗的疗效观察

摘要

Objective: To observe the effect of early intensive lipid lowering treatment on the patients with acute coronary syndrome. Method: 69 patients with acute coronary syndrome were divided into two groups randomly. Conventional treatments were given in both groups. Simvastatin 40mg were given while the patients were in hospital at once, and 40mg qn for 3 months in the intensive group; Simvastatin 20mg qn were given in the convention group. The total cholesterol ( TC ), low density lipoprotein cholesterol ( LDLC), triglyceride( TG), high density lipoprotein cholesterol (HDL-C), C-reactive protein (CRP), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were observed before treatment and at the end of 3 months after treatment in both groups. Main cardiovascular events were observed also. Result:The TC, LDL-C, CRP, TG before treatment and at the end of 3 months after treatment in convention group were 5.53±0.55mmoL/L、4.51 ±0.39mmoL/L 、3.78±0.33mmoL/L、2.76±0.28mmoL/L 、0.81 ±0.24mmoL/L、1.05±0.22 mmoL/L、2.56 ±0.38mmoL/L、 1.83 ±0.22mmoL/L、2.14 ±0.49mmoL/L、0.79 ±0.32mmoL/L; while those were 5.89 ±0.49mmoL/L、4.07 ±0.35mmoL/L、3.91 ±0.43mmoL/L、2.49 ±0.23mmoL/L、0.76±0.19mmoL/L、1.08 ±0.20mmoL/L、2.33 ±0.22mmoL/L、 1.68 ±0. 17mmoL/L、 1.99 ±0.57mmoL/L、0.67±0.26mmoL/L in the intensive group; The rate of angina, myocardial infarction, and sudden cardiac death in the convention group were 52.2％, 34.8％, 26.1％; while they were 26.1％, 8.7％,4.3％ in the intensive group. Conclusion: It can decrease the rates of cardiovascular events by the early intensive lipid lowering treatment on acute coronary syndrome patients, and the intensive dose is feasible and safe.%目的:研究急性冠脉综合征患者早期强化调脂治疗的疗效.方法:69例急性冠脉综合征患者随机分为两组,在常规治疗的基础上,强化组入院时立即给予阿托伐他汀40mg口服,之后每晚口服40mg 3个月,对照组常规给予每晚口服阿托伐他汀20mg 3个月.监测入院时及治疗3个月后的TC、LDL-C、HDL-C、TG、CRP、ALT、AST水平,并随访一年的心绞痛发生率、(再发)心肌梗死发生率、心源性猝死发生率.结果:对照组入院时及治疗3个月后的TC、 LDL-C、HDL-C、TG、CRP水平分别为:5.53±0.55mmoL/L、4.51±0.39mmoL/L 、3.78±0.33mmoL/L、2.76±0.28mmoL/L 、0.81±0.24 mmoL/L、1.05±0.22 mmoL/L、2.56±0.38mmoL/L、1.83±0.22mmoL/L、2.14±0.49mmoL/L、0.79±0.32mmoL/L;相应的强化组结果为: 5.89±0.49mmoL/L、4.07±0.35mmoL/L、3.91±0.43mmoL/L、2.49±0.23mmoL/L、0.76±0.19mmoL/L、1.08±0.20mmoL/L、2.33±0.22mmoL/L、1.68±0.17mmoL/L、1.99±0.57mmoL/L、0.67±0.26mmoL/L;随访一年,对照组的心绞痛发生率、(再发)心肌梗死发生率、心源性猝死率为36.4%、17.4%、12.1%,强化组相应为:25%、8.7%、5.6%,两组相比差异有显著性.结论:急性冠脉综合征患者早期强化调脂治疗能更好的降低TC、LDL-C、TG、CRP水平,升高HDL-C水平,降低心血管不良事件发生率,并具有良好的安全性.