不同剂量阿托伐他汀治疗急性冠脉综合征的疗效

Therapeutic effect of atorvastatin therapy of different doses on acute coronary syndrome

目的:探讨阿托伐他汀治疗急性冠脉综合征(ACS)的最佳剂量。方法:86例ACS患者被随机分为阿托伐他汀大剂量组(40mg/d)和常规剂量组(20mg/d),每组43例,比较两组治疗前后血脂水平及达标率,及血清脂联素(APN)、超敏C反应蛋白(hsCRP)水平变化,出院后继续随访6个月,比较两组心血管事件发生率及不良反应发生率。结果:治疗后3个月,大剂量组TC、LDL-C水平显著低于常规剂量组(P<0.01或<0.05);与常规剂量组比较,大剂量组TC、LDL-C达标率[TC:(23.3%比44.2%),LDL-C:(37.2%比60.5%),P均<0.05]均明显升高;APN水平[(8.47±1.73)mg/L比(12.96±2.15)mg/L]升高更显著,hsCRP水平[(6.23±1.26)mg/L比(4.07±1.54)mg/L]降低更显著(P均<0.01);心血管不良事件发生率(23.3%比7.0%,P=0.035)显著降低,两组不良反应发生率比较差异无统计学意义(P=0.213)。结论:阿托伐他汀可有效降低急性冠状动脉综合征患者心血管事件发生率,40mg/d为最佳剂量。

Objective：To explore the optimal dose of atrovastatin treating acute coronary syndrome （ACS） .Methods：A total of 86 ACS patients were randomly and equally divided into atorvastatin large dose group （40 mg/d） and rou-tine dose group （20 mg/d ） . Blood lipid levels , blood lipid standard-reaching rate , serum levels of adiponectin （APN） and high sensitive C reactive protein （hsCRP） were compared between two groups before and after treat-ment .All patients were followed up for six months after discharge ,and incidence rates of cardiovascular events and adverse reactions were compared between two groups .Results：Compared with routine dose group ,the levels of TC and LDL-C significantly reduced on 3 months after treatment ,in large dose group （P〈0.01 ,〈0.05 respectively）;the standard-reaching rates of TC and LDL-C [TC：（23.3% vs .44.2% ） ,LDL-C：（37.2% vs .60.5% ） ,P〈0.05 all];level of APN [ （8.47 ± 1.73） mg/L vs .（12.96 ± 2.15） mg/L] significantly rose ,level of CRP [ （6.23 ± 1.26） mg/L vs .（4.07 ± 1.54） mg/L] significantly reduced ,P〈0.01all;incidence rate of adverse cardiovascular e-vents （23.3% vs .7.0% , P= 0.035） significantly reduced ,but there was no significant difference in incidence rate of adverse reactions between two groups ,P=0.213.Conclusion：Atorvastatin therapy can effectively reduce in-cidence rate of cardiovascular events in ACS patients ,and the dose 40mg/d is optimal dose .