急性冠脉综合征初期患者不同剂量阿托伐他汀短期治疗对内皮功能的影响

Comparison of the short-term effect of different dose of atorvastatin on endothelial function in patients with acute coronary syndrome

目的:观察急性冠脉综合征患者初期予不同剂量阿托伐他汀短期治疗对一氧化氮、内皮素-1的影响,探讨急性冠脉综合征初期应用他汀类药物的必要性和有效性。方法:71例急性冠脉综合征患者随机分为阿托伐他汀40mg治疗组(26例)、阿托伐他汀20mg治疗组(25例)和常规治疗组(20例),测定治疗前后一氧化氮、内皮素-1的水平及血脂、肝功能等指标。结果:(1)3组病例治疗前后血脂各指标变化差异均无显著性(P>0.05)。(2)阿托伐他汀40mg治疗组和阿托伐他汀20mg治疗组治疗后3d的一氧化氮水平均明显升高,与治疗前比较有统计学差异(P<0.05),与对照组治疗后比较亦有统计学差异(P<0.05);与阿托伐他汀20mg治疗组比较,阿托伐他汀40mg治疗组治疗后3d的一氧化氮水平升高更明显,2组比较有统计学差异(P<0.05)。(3)内皮素-1水平3组患者治疗前后比较均无统计学差异(P>0.05)。结论:急性冠脉综合征初期予阿托伐他汀短期治疗,即可明显升高一氧化氮水平,对改善内皮功能有利,剂量偏大效果更明显。

OBJECTiVE To observe the influence of different dose of atorvastatin on NO and ET-1 in patients with acute coronary syndrome （ACS） within the first 3 days after the coronary events. METHODS Seventy-one patients with ACS were divided randomly into atorvastatin 40 mg group, atorvastatin 20 mg group and control group. Levels of NO, ET-1 and lipid were detected before and after treatment. RESULTS ① Levels of lipid were not changed significantly bofore and after treatment in the three groups（P〉0. 05）. ②The level of NO were increased significantly in both atorvaststin 40 mg group and atorvaststin 20 mg group than these in the control group （P〈0. 05）, but the change was more significant in the atorvaststin 40 mg group than in the atorvastatin 20 mg group （P〈0. 05）. ③The level of ET-1 had not changed differently bofore and after in the three groups （P〉0 05）. CONCLUSION Atorvastatin could increase the level of NO in patients with ACS within the first 3 days after the attack of this coronary event. Therefore it may be benefit to the function of vascular endothelial. The higher dose, the more benefit.