阿托伐他汀对急性冠状动脉综合征病人疗效观察

Effect of atorvastatin in patients with acute coronary syndrome

目的研究不同剂量的阿托伐他汀对急性冠状动脉综合征病人血脂、基质金属蛋白酶(matrixmetalloproteinases,MMP)、高敏C反应蛋白C(highsensitivity-Creactiveprotein,hs-CRP)水平和生活质量的影响。方法选取我院急性冠状动脉综合征病人51例,随机分为小剂量治疗组28例,口服阿托伐他汀10mg,每日1次,共30d;大剂量治疗组23例,口服阿托伐他汀80mg,每日1次,共30d,治疗前和治疗30d时测定血脂、MMP-1、MMP-9、金属蛋白酶组织抑制物和hs-CRP,并进行活动平板检查。病人每周接受门诊或电话随访。结果30d后,两治疗组血脂水平、血清MMP-1、MMP-9、hs-CRP水平均降低,两组下降程度差异有统计学意义。胸痛发作次数减少,硝酸甘油用量减少和运动平板运动持续时间增加,两组相比差异有统计学意义(P<0.05)。结论阿托伐他汀治疗可减少急性冠状动脉综合征病人斑块基质成分降解和炎症反应,改善病人生活质量,大剂量阿托伐他汀应用获益更多。

Objectives To study effects of difference dose atorvastatin in patients with acute coronary syndrome. Methods A total of 51 patients with acute coronary syndrome were divided into two groups randomly-one group had 28 patients and was given low dose atorvastatin （10mg a day） for 30 days and the other group had 23 patients and took large dose atorvastatin （80 mg a day）for 30 days also. The serum levels of serum lipid, MMP-1,MMP-9, tissue inhibitor of matrix metalloproteinases （TIMP-1） and high sensitivity-C reactive protein （hs-CRP） were detected before and after therapy. Some clinical data such as symptoms and treadmill exercise test were compared before taking medicine and every week later in the total of 30 days. Results 30 days later, the levels of MMP-1, MMP-9, hs-CRP decreased signlficanfly and had statistical difference between two groups （P〈0.05）. During the follow-up, the times of the anginal attacks in every week, the consumption of nitroglycerine pills, and the total times of exercises had statistical difference between two groups （P〈0.05）. Conclusions Atorvastafin can decrease breakdown of matrix collagen and inflammatory reaction, and elevate the qualities of life in patients with acute coronary syndrome,especially in patients taken large doses.