阿托伐他汀钙序贯治疗在ACS患者应用的安全性研究

Clinical Effect and Safety of Sequential Therapy of Atorvastatin on Acute Coronary Artery Syndrome Patient Undergoing PCI

目的探讨阿托伐他汀钙序贯治疗(患者均在经皮冠状动脉介入治疗术(PCI)前24h内给予阿托伐他汀钙80mg,再以每日40mg,维持1个月)在急性冠脉综合征(ACS)患者应用的安全性研究。方法选择滁州市第一人民医院收治的ACS患者120例,随机分为阿托伐他汀钙常规治疗组A组(20mg/d)和阿托伐他汀钙序贯组B组,收集两组临床资料,并监测入院用药前、用药后1、4、7、14、21、30天肝肾功能、肌酶指标。记录PCI术后30天内两组主要心血管不良事件(MACE)。结果两组用药后比较:ALT升高<3倍正常值上限(ULN),A组12.50%和B组29.63%,差异有统计学意义(P=0.03),并且均发生在1周内;ALT≥3ULN,A组3.57%和B组5.56%,差异无统计学意义(P=0.97);碱性磷酸酶>1ULN、总胆红素>1ULN、肌酸激酶>10ULN无明显变化,差异无统计学意义(P>0.05)。两组主要MACE发生率,A组20.69%和B组7.27%,差异有统计学意义(P=0.04)。结论阿托伐他汀钙序贯治疗除早期存在一过性ALT轻度升高外,无其他严重不良反应的增加;阿托伐他汀序贯治疗减少主要MACE的发生。

Objective To observe the clinical effect and safety of sequential therapy of atorvastatin on acute coronary artery syn- drome （ACS） patient undergoing percutaneous coronary intervention （ PCI）. Methods The clinical data of 120 consecutive patients with ACS who were treated in the first people＇s hospital of chuzhou were analyzed. All of the patients were enrolled into 2 groups. Group A re- ceived only post - PCI atorvastatin 20rag for 30 days and group B received 80 mg of atorvastatin before PCI, and post - PCI follow - up atorvastatin 40rag for 30days. Alanine aminotransferase （ALT） , alkaline phosphatase （ALP） , total bilirubin （TBL） , creatinine （Cr） , Cre- atine kinase （CK） were measured before administration and after 1,4,7,14,21,30days. 30 - day major adverse cardiac event （MACE） after PCI was monitored. Results After treatment,one times upper limit of normal （ULN） 〈 ALT elevation 〈 3 ULN 12.50% （A） and 29.63% （B） was found,and the difference was statistically signifieant（P =0.03）. ALT elevations〉3 ULN 3.57% （A） and 5.56% （B） was found, and the difference was not statistically significant（ P = 0.97 ）. ALP elevation 〉 1 ULN,TBL elevation 〉 1ULN, CK elevation 〉 10ULN were found, and the difference was not statistically significant （ P 〉 0.05 ）. MACE ,20.69% （A） and 7.72% （B） were found, and the difference was statistically significant （ P = 0.04）. Conclusion Sequential therapy of atorvastatin is safety in ACS patient. Atorvastatin sequential therapy can reduce the MACE in ACS patients 30days after PCI.