大剂量阿托伐他汀治疗急性冠脉综合征的疗效及安全性

Effects and safety of high-dose atorvastatin treatment in patients with acute coronary syndrome

目的:观察急性冠脉综合征(ACS)发生后24h内使用两种不同剂量阿托代他汀的疗效与安全性,以及患者1年中心脑血管事件的发生情况。方法:60例ACS患者被随机均分为两组,24h内分别给予阿托伐他汀20mg/d与60mg/d,用药时间1年。观察两组患者血脂变化情况、住院期间及存活出院者主要心脑血管事件及药物不良反应。结果:两组治疗2周、3个月、6个月及12个月的总胆固醇(TC)及低密度脂蛋白(LDL-C)均明显降低(P均<0.01),且60mg/d组在各时间段的下降程度均优于20mg/d组(P均<0.05),住院及随访期间60mg/d组复发性心绞痛(10.0%:30.0%)、心力衰竭(10.0%:26.7%)、心律失常发生率(13.3%:30.0%)均较20mg/d组明显降低(P均<0.05)。两组未见严重不良反应。结论:ACS患者应用20mg/d及60mg/d的阿托伐他汀均能有效地调脂,60mg/d阿托伐他汀的调脂及减少心脏血管事件作用更佳,且治疗过程中无严重不良反应。

Objective： To observe the effects and safety of two different doses of atorvastatin in patients with acute coronary syndrome （ACS） since 24 h after it happened and to observe the incidence of cardio-cerebral vascular events in one year. Methods： The 60 ACS patients were randomly averagely divided into two groups, atorvastatin 60mg group and atorvastatin 20rag group, 60rag or 20rag a day respectively for one year. Results： The levels of total cholesterol （TC） and low dense lipoprotein （LDL C） significantly decreased after two weeks, three months, six months and one year as compared with base levels in both groups （P〈0.01 all）. The effect of regulating lipid in atorvastatin 60rag group was superior to that of atorvastatin 20 mg group in every time segments （P〈0.05 all）. In atorvastatin 60mg group, the incidences of cardio-cerebral vascular events such as recurrent angina pectoris （10.0% vs. 30.0%）, heart failure （10.0% vs. 26.7%）, arrhythmia （13.3% vs. 30.0%） were lower than those of 20mg group during hospitalization and 12-month＇s follow-up period （P〈0.05 all）. There were no serious adverse events in two groups. Conclusion： Atorvastatin both 20mg or 60rag are effective in regulating lipid and decreasing the incidence of cardio--cerebral vascular events, but the efficacy of 60mg is superior to those of 10rag. There are no serious adverse reactions during the course of treatment in two groups.