早期应用不同剂量阿托伐他汀治疗老年急性冠脉综合征的疗效

Therapeutic effect of atorvastatin with difference doses on early acute coronary syndrome in aged patients

目的:观察老年急性冠状动脉综合征(ACS)发病早期应用不同剂量的阿托伐他汀的临床疗效及安全性。方法:选择临床确诊为ACS的老年患者117例,随机分为阿托伐他汀10mg组(58例)和20mg组(59例),均为每晚服药一次,患者分别于用药前,用药后1个月、3个月测定总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)及高敏C反应蛋白(hsCRP),随访3个月内所有不良反应,观察主要不良心血管事件(MACE)的发生率。结果:(1)与治疗前比较,两组服药后第1个月、3个月的TC、LDL-C、hsCRP水平均明显降低(P均<0.05),且3个月后与10mg组比较,20mg组下降水平TC[(4.07±1.03)mmol/L比(5.02±1.08)mmol/L]、LDL-C[(2.24±0.77)mmol/L比(3.03±1.07)mmol/L]、hsCRP[(27.90±1.90)mg/L比(36.00±3.80)mg/L]更显著(P均<0.05);(2)20mg组累计MACE发生率较10mg组显著减少(5.1%比19.0%,P<0.05);(3)两组不良反应发生率无显著差异,均无严重不良反应。结论:在急性冠脉综合征早期应用阿托伐他汀20mg/d,能更有效地降脂,抑制炎症因子,减少心脏血管事件的发生率,而且安全。

Abstract： Objective： To observe clinical therapeutic effect and safety of atorvastatin with different doses on early a- cute coronary syndrome （ACS） in aged patients. Methods： A total of 117 ACS aged patients were randomly divided into atorvastatin 10mg group （n= 58） and 20mg group （n= 59） . Levels of total cholesterol （TC）, low density lipo- protein-cholesterol （LDL-C）, high density lipoprotein-cholesterol （HDL-C）, triglyceride （TG） and high sensitive C --reactive protein （hsCRP） were measured before, one and three months after treatment. All adverse reactions and incidence rates of major adverse cardiovascular events （MACE） were followed up during three months after treatment. Results： （1） Compared with before treatment, levels of TC, LDL-C and hsCRP significantly decreased in the two groups on first and third month after treatment （P〈0.05 all）. After third month, compared with 10 mg group decrease levels of TC F （4.07±1.03） mmol/L vs. （5.02±1.08） mmol/L], LDL-C [ （2.24±0.77） mmol/L vs. （3. 03±1.07） mmol/L] and hsCRP [ （27.90±1.90） mg/L vs. （36.00±3.80） mg/L] more than those in 20 mg group （P〈0.05 all）; （2） Overall incidence rates of MACE in 20 mg group was significantly lower than that of 10 mg group （5.1% vs. 19.0%, P〈0.05） ; （3） There was no significant difference in incidence rate of adverse reac- tions between the two groups and no severe adverse reactions occurred. Conclusion： Application of atorvastatin 20 mg/d in early ACS can effectively lower blood lipids, and inflammatory factors, decrease MACE rate, and is safe.