大剂量阿托伐他汀联合替罗非班对急性冠脉综合征患者颈动脉粥样硬化的影响

Effects of high dosage of atorvastatin in acute coronary syndrome patients on hsCRP and carotid atherosclerosis

目的观察急性冠脉综合征（ACS）患者使用大剂量阿托伐他汀联合替罗非班对血浆超敏C反应蛋白（hsCRP）及颈动脉粥样硬化的影响。方法对126例ACS患者随机分三组，A组30例，每晚服用20mg阿托伐他汀；B组41例，每晚服用阿托伐他汀40mg；C组55例，采用每晚服用阿托伐他汀40mg，联合24，48h替罗非班。随访6个月，观察血浆hsCRP、彩色多普勒技术测定颈动脉内一中膜厚度（IMT）变化。结果三组治疗12个月，均能显著降低hsCRP，且三组比较差异有显著性；B、C两组能降低双侧IMT，且两组之间有显著性差异。结论ACS应用大剂量阿托伐他汀联合替罗非班治疗，明显抑制hsCRP，减少颈动脉粥样硬化，降低心脏事件发生。

Objective To study effects of high dosage of atorvastatin in acute coronary syndrome（ACS） patients on high sensitive creactive protein（hsCRP） and atherosclerosis. Methods 126 cases with ACS were divided into A, B and C group. 30 patients in A group were given atorvastatin 20mg per night,41 cases in B group were given atorvastatin 40mg per night, while the other 55 patients in C group were taken atorvastatin 40mg per night and tirofiban in the first 24 to 48 hours. The patients were followed 6 months by evaluating serum hsCRP concentration, measuring the intimal thickness in the carotid artery with color Doppler. Results After treatment for 6 months, the patients in the three groups showed significant decrease in hsCRP, however, the therapeutic group showed significant difference amony the three groups. Additionally, the B and C groups further showed significant decrease in intimal thickness. Conclusion Using high-dose atorvastatin and tirofiban not only lowers hsCRP significantly,but also benefit stability of atherosclerotic plaque in carotid artery, and to reduce cardiovascular events.