急性冠脉综合征早期辛伐他汀强化降脂安全性及有效性观察

Efficacy and Safety of Early Aggressive Lipid - Lowering with Simvastatin in Patients with Acute Coronary Syndrome

目的:观察急性冠脉综合征(ACS)患者早期强化降脂治疗的安全性和有效性。方法:选择临床确诊为ACS的71 名患者,随机分为住院起始剂量辛伐他汀40mg组和20mg组,均为每晚服药1次。分别于用药前,用药4周,12周采空腹 静脉血,以酶法测定总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)及肝 肾功能,高敏C反应蛋白(hsCRP)。所有患者服药期间记录心血管事件发生情况。结果:(1)用药第4周、12周的TC、 LDL-C和hsCRP水平,40mg组比20mg组明显降低。(2)两组间谷丙转氨酶(ALT)升高等副作用未见明显差异。结论: ACS患者早期服用40mg辛伐他汀能够更有效的降低TC和LDL-C水平,且具有良好的安全性。

Objective: Toevaluate whether early aggressive lipid-loweringwith simvastatin is safe and efficient in patients with acute coronary syndrome(ACS), who are at risk of majorevents.Methods: The study was a randomized,open, two-dosage controlle d trial. 71 patients with definite diagnosis of ACS were enrolled and divided into two groups initiated with 40mg and 20mg simvastatin. The fasting serum levels of total cholesteral(TC) ,low-density lipoprotein cholesteral(LDL-C) ,high-density lipoprotein cholesteral(HDL-C) and triglyceride(TG) as well as furictionsof liver and kidney,hsCRP were determined after admission and4,12weeks later. During the following-up, all adverse events and cardiovascular events were recorded. Results: The levels of TC and LDL -C were decreased significantly at 4th, 12th week after initial medication, and at the same time ,TC and LDL - C levels in 40mg group were continuously lower than those in 20mg group. There were no statistical differences in adverse effects including abnormal liver enzyme between the two groups. Conclusion: The results suggest that early aggressive intervention with HMG - CoA reductase inhibitor simvastatin to ACS is feasible and safe.