早期应用不同剂量阿托伐他汀治疗急性冠脉综合征的疗效观察

Therapeutic effect of early application of different doses of atorvastatin on acute coronary syndrome

目的随机对比观察急性冠脉综合征(ACS)发生后24小时内使用2种不同剂量阿托代他汀的疗效与安全性,以及1年中心脑血管事件的发生情况。方法将确诊的ACS患者111例随机分为2组:服阿托伐他汀标准剂量10mg组与20mg组,随访1年,观察调脂疗效、心脑血管事件发生情况及药物不良反应。结果2组在治疗2周、3个月、6个月及12个月后与治疗前相比均能显著降低总胆固醇(TC)、低密度脂蛋白胆固醇(LDLC)水平(P<0.01)。2组甘油三酯(TG)则在治疗的第3个月后与治疗前相比有明显降低(P<0.05)。随访期2组高密度脂蛋白胆固醇(HDLC)水平有逐渐升高的趋势,仅在12个月后方有显著差异(P<0.05)。20mg组的调降脂作用明显优于10mg组(P<0.05)。在住院期间20mg组复发性心绞痛(AP)、心力衰竭(HF)、心律失常较10mg组明显降低(P<0.05),随访期间20mg组AP、HF、心律失常、PTCACABG、因心肌缺血再住院较10mg组明显降低(P<0.05)。结论ACS患者应用20mgd及10mgd的阿托伐他汀均能有效的调脂,20mgd的阿托伐他汀调脂及减少心脑血管事件作用更佳。治疗过程中无严重不良反应,阿托伐他汀具有良好的安全性及耐受性。

Objective To investigate the efficacy and safety of two different doses of atorvastatin in treating acute coronary syndrome（ACS） and to observe the incidence of cardiocerebral vascular events in one year.Methods 111 patients with ACS were randomly divided into two groups. They were treated with atorvastatin 10mg and 20mg a day respectively. The patients were followed up for one year. The effect of the two doses of atorvastatin on regulating lipid, incidence of cardiocerebral vascular events and side effect of atorvastatin were observed. Results The levels of total cholesterol （TC） and low dense lipoprotein（LDL-C） were significandy decreased, as compared with base levels in both groups after 2 weeks, 3 months, 6 months and 12 months （ P 〈 0.01 ）. The levels of triglyceride （TG） were also signiticanfly decreased,as compared with base levels in both group after 3 months,6 months, 12 months （ P 〈 0.05）. The levels of high dense lipoprotein （HDL-C） were significantly increased, as compared with base levels in both group after 12 months （ P 〈 0.05）. Furthermore, the effect of regulating lipid in 20mg atorvastatin group was superior to that of 10 nag atorvastatin group （ P 〈 0.05）. In 20 nag group, the incidence of cardiocerebral vascular events such as recurrent angina pectoris（AP）, heart failure （HF）, arrhythmia was lower than that of 10mg group during hospitalization （ P 〈 0.05） .During the 12-month＇s follow-up the incidence of AP,HF, PTCA/CABG, arrhythmia and re-hospitalization in 20 nag group was significantly lower than that in l Omg group （ P 〈 0.05）. Conclusion Both 10mg atorvastatin and 20 nag atorvastatin are effective and safe in regulating lipid. The efficacy of 20mg atorvastatin is superior to that of 10mg atorvastatin in regulating lipid and decreasing the incidence of cardioeerebral vascular events.