阿托伐他汀在急性冠脉综合征患者中的早期应用

Early treatment with atorvastatin in patientswith acute coronary syndrome

目的观察阿托伐他汀对急性冠脉综合征(ACS)患者早期超敏C反应蛋白(hs-CRP)、基质金属蛋白酶-9(MMP-9)、血脂及心脑血管事件的干预效果。方法103例ACS患者随机分为阿托伐他汀治疗组(55例)和常规治疗对照组(48例),分析比较组间及阿托伐他汀治疗(10 mg/d)前和治疗后2、4周总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三脂(TG)、hs-CRP和MMP-9水平的变化,同时观察ACS患者半年随访期间主要心脑血管事件发生情况。结果阿托伐他汀(10 mg/d)治疗2周后,仅hs-CRP及MMP-9水平较前明显降低(P<0.05),治疗4周后TC、LDL-C、hs-CRP及MMP-9均显著降低(P<0.05),与常规治疗对照组治疗后相比亦明显下降(P<0.05),阿托伐他汀治疗组半年随访期间复发性心绞痛、心力衰竭、心律失常等均较常规治疗组明显降低(P<0.05)。结论阿托伐他汀早期治疗可以明显降低hs-CRP、MMP-9水平,减轻炎症反应稳定斑块并改善预后。

Objective：To observe the effects of atorvastatin on hight sensitivity C - reactive protein（ hs -CRP）, matrix metallopreteinase -9 （ MMP- 9）, blood lipid and cardiovascular events in patients with acute coronary syndrome （ACS） in early stage. Method： The 103 ACS patients were randomly divided into routine treatment control group （ n =48） and treatment group （ n = 55） with added atorvastatin 10 mg per day with 48 h from onset. The levels ofTC, LDL-C,HDL-C,TG, hs - CRP, and MMP - 9 before and after two and four week treatmet and major cardiovascular events in 6 months were observed. Results ： After two weeks treatment with atorvastain 10 mg per day , the levels of hs - CRP and MMP - 9 decreased significantly than per - treatment（ P 〈 0.05 ） o After 4weeks treatment, TC, LDL - C, hs - CRP and MMP - 9 were all lowered significantly （ P 〈 0.05 ）, Comparing with the general treatment group, they were decreased significantly too （ P 〈 0.05 ）. There were relatively lower recurrent angina pectoris, congestive heart failure and arrhypthmia than control group during the 6 months follow up（P 〈 0.05） Conclusion： Comparing with the general treatment group, atorvastain show better effects on decreasing levels of hs - CRP and MMP - 9 in early stage, stable atherosclerotic plaque and improve clinic prognosis.