阿托伐他汀治疗对急性冠脉综合征患者血浆内皮素-1水平、心功能和心肌酶的影响

摘要

目的：探讨阿托伐他汀治疗对急性冠脉综合征（ACS）患者血浆内皮素-1（ET1）水平、心功能和心肌酶的影响。方法：回顾性分析2013年6月-2015年3月本院收治的130例ACS患者，根据其治疗方法分为研究组100例和对照组30例。研究组采用常规ACS基础治疗，并口服阿托伐他汀钙，40 mg/次，1次/d，每晚睡前服用，连续服用8周；对照组仅接受基础治疗。比较两组治疗前（T0）、治疗1周（T1）、2周（T2）、4周（T3）和8周（T4）的血浆ET1水平、心肌酶指标和LVEF，统计研究组不良反应和并发症发生情况。结果：与对照组同期比较，T0时两组患者血浆ET1、LVEF及心肌酶水平并无明显差异（P>0.05）；但在T1~T4时期研究组血浆ET1和LVEF水平明显低于同期对照组，且CK-MB、CK和LDH亦明显低于同期对照组，比较差异有统计学意义（P<0.05）。两组患者头晕、口干、乏力、消化道反应等不良反应和并发症的总发生率均较低，但比较差异无统计学意义（P>0.05）。结论：基础治疗上辅以阿托伐他汀治疗有助于降低ACS患者血浆ET1水平和心肌酶指标，提高LVEF，改善患者血管内皮功能和心功能且不良反应和并发症发生少，具有良好的可行性和安全性，值得临床推广使用。%Objective: To explore the impact of atorvastatin on plasma endothelin 1 (ET1) level and myocardial enzyme level when treating patients with acute coronary syndrome (ACS).Method: 130 ACS patients in our hospital from June 2013 to March 2015 were selected, and according to treatment, divided into study group (100 cases) and control group (30 cases). The study group adopted conventional ACS foundation treatment and oral atorvastatin calcium treatments (40 mg/time, 1 time/d, taking at every night before sleeping, treated for eight weeks). The control group only received foundation treatment. Before treatment (T0), after treated 1 week (T1), 2 weeks (T2), 4 weeks (T3), and 8 weeks (T4), plasma ET1 level, myocardial enzyme index, and LVEF between the two groups were compared, and adverse reaction and complications of the study group were statistically analyzed.Result: Compared with the control group, there was no significant difference in the plasma ET1, LVEF, and myocardial enzyme levels of the study group at T0 (P<0.05), but the plasma ET1, LVEF, and myocardial enzyme level of the study group was significant less than that of the control group at T1-T4 (P<0.05). Both the two groups with dizziness, dry mouth, fatigue, the total incidence of adverse reaction and complications such as digestive tract reaction were low, and there was no obvious difference (P>0.05).Conclusion: Atorvastatin therapy based on basic treatment can help to reduce plasma ET1 level and myocardial enzyme index of ACS patients, improve LVEF, endothelial function, and heart function without few adverse reaction and complications, thus it has good feasibility and safety and worthy of clinical use.