辛伐他汀早期干预对急性冠脉综合征患者心功能和心律失常的影响

Effect of early treatment with Simvastatin on cardiac function and arrhythmia in patients with acute coronary syndrome

目的观察不同剂量辛伐他汀早期干预对急性冠状动脉综合征(ACS)患者心功能和心律失常的影响。方法78例ACS患者随机分为3组,A组(24例)为常规药物治疗,B组(26例)为常规药物治疗加辛伐他汀20 mg/d,C组(28例)为常规药物治疗加辛伐他汀40 mg/d,疗程均为10 d。每日心电监测并记录心律失常,治疗前和疗程结束后用超声心动图测定心功能参数、检测肝肾功能及心肌酶学。结果辛伐他汀20 mg与40 mg治疗10 d后:左心室舒张末内径(LVEDD)、左室收缩末内径(LVESD)及NYHA分级显著下降(P<0.01),左室射血分数(LVEF)显著升高(P<0.01),心律失常的发生率显著减少(P<0.01),其中40 mg剂量组的疗效明显优于20 mg剂量组。结论早期大剂量辛伐他汀干预能安全有效地改善ACS患者的心功能,降低心律失常的发生率,且呈剂量依赖性。

AIM To observe the effect of early treatment with Simvastatin of different doses on the cardiac function and arrhythmia in patients with acute coronary syndrome （ACS）. METHODS Seventyeight patients with ACS were randomly divided into three groups： group A （24 cases） with no Simvastatin treatment, group B （26 cases） with Simvastatin 20 mg daily and group C （28 cases） with Simvastatin 40 mg daily. The three groups were treated for l0 days and arrhythmia was recorded by electrocardiogram each day. Hepatic and renal functions were detected and the parameters of cardiac function were evaluated by ultrasonic cardiogram before and after treatment. RESULTS After the 10-day treatment, the left ventricular end-diastolic diameter, left ventricular end-systolic diameter and NYHA grades significantly decreased, while left ventricular ejection fraction increased and the occurrence of arrhythmia was obviously reduced （P 〈 0.01 ） in both 20mg and 40mg Simvastatin treatment groups, with higher efficacy in 40mg Simvastatin group than that in 20mg group. CONCLUSION Early Simvastatin treatment effectively improves the cardiac function in ACS patients in a dose-dependent manner.