目的：探讨急性冠状动脉综合征（ACS）患者住院期间短期大剂量阿托伐他汀强化治疗的有效性及安全性。方法选取ACS患者355例，其中强化组180例（入院即给予阿托伐他汀80mg，无论是否行冠脉介入治疗，均在住院期间予阿托伐他汀80mg/晚），常规组175例（入院起予阿托伐他汀20mg/晚）。两组患者均于入院时及入院后1周后均予生化检查[包括有效性指标（TG、TC、HDL- C、LDL- C）及安全性指标（ALT、AST、Cr、CK、CK- MB）]并记录结果。结果两组患者治疗1周后，TC、TG、LDL- C水平均显著下降，HDL- C水平均显著升高，差异均有统计学意义（均P＜0.01）；与常规组比较，强化组TG水平升高更明显，差异有统计学意义（P＜0.05）。两组患者治疗1周后Cr、CK、CK- MB均较治疗前明显改善，差异均有统计学意义（均P＜0.01）；与常规组比较，强化组ALT及AST水平升高更明显，差异均有统计学意义（均P＜0.01）。结论80mg短期阿托伐他汀强化治疗的安全性与20mg相同，能迅速有效降低患者TG、TC和LDL- C水平，提高HDL- C水平，临床获益更大。%Objective To evaluate the efficacy and safety of short- term high doses of atorvastatin intensive treatment for patients with acute coronary syndrome (ACS) during hospitalization. Methods A total of 355 ACS patients who were treated in our hospital were enrol ed into this study. Among them 180 cases received atorvastatin 80mg at admission and atorvastatin 80mg/night during the hospitalization (intensive group), and other 175 cases received atorvastatin 20mg/night) from admission (convention group). The serum levels ALT, AST, Cr, TG, TC, HDL- C, LDL- C, creatine kinase (CK) and creatine kinase isoenzyme (CK- MB) at admission and 1 week after admission were measured in both groups. Results The TC, TG and LDL- C levels were significantly lower and HDL- C levels were significantly higher at 1 week after treatment than those at baseline levels in both groups (al P<0.01);while The TG levels in intensive group were significantly higher than those in conventional group 1 week after treatment (P<0.05). The ALT, AST, Cr, CK and CK- MB levels were improved significantly in both groups 1 week after treatment (P<0.01);while compared with the conventional group, the ALT and AST levels in intensive group were markedly increased (P<0.01). Conclusion The short- term intensive statin therapy is as safe as the conventional treatment, but is more effective for pa-tients with acute coronary syndrome.
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