阿托伐他汀强化治疗对急性冠脉综合征BNP及血脂的影响

Early effects of intensified atorvastatin treatment on BNP and blood lipids in patients with acute coronary syndrome

目的探讨阿托伐他汀强化治疗短期内对急性冠脉综合征(ACS)患者血浆B型钠尿肽(BNP)及血脂的影响。方法将入院后24h内予常规治疗(溶栓剂、抗凝剂、ACEI、β受体阻滞剂、钙通道拮抗剂、硝酸酯类等)的46例ACS患者随机分为常规治疗组和强化治疗组。正常体检者23例为对照组,观察治疗前及治疗5d后检测血浆BNP、血脂。结果常规治疗组与强化治疗组ACS患者入院治疗前后的血脂TC、TG、HDL及LDL-C水平无差别(P>0.05)。常规治疗组与强化治疗组患者治疗前血浆BNP较对照组明显增高(P<0.01),治疗5d后,常规治疗组及强化治疗组血浆BNP水平有差别(P<0.01),且强化治疗组更为显著(P<0.01)。结论 ACS急性发病期存在心功能障碍;阿托伐他汀强化及常规短期治疗对ACS患者均能降低血浆BNP水平;这种作用独立于降脂作用,可能与剂量有关。

Aim To observe the early effects （5 days） of intensified atorvastatin treatment on BNP （B-type natriuretic peptide） and serum lipids in patients with acute coronary syndrome（ACS）. Methods Forty-six ACS patients were given conventional treatments （including thrombelytic agents, anticoagulants, ACEI,calcium channel antagonists and nitrates, etc） within 24 hours after being hospitalized, and then divided randomly into two groups：conventional therapy group（atorvastatin 20mg QN） and intensified treatment group（ atorvastatin 40mg QN）. Five days before and after treatment, the levels of plasma BNP and hpids were detected. In addition,23 persons were taken as control group. Results There no significant difference in the levels of plasma TC ,TG,LDL,HDL were observed before and after treatment（P〉0.05）in the two groups. The levels of plasma BNP in the conventional therapy group and the enhanced treatment group before the treatment were much higher than that of the control group （P〈0.01）. The plasma BNP level in the intensified treatment group was decreased significantly compared with that of the conventional group （P〈0.01）. Conclusions ACS Patients suffer from heart dysfunction. The atorvastatin can obviously reduce the level of plasma BNP,which is independent on lowering lipids relevant to the dosage.