辛伐他汀在不稳定型心绞痛患者早期应用的疗效

Efficacy and safety of Simvastatin in early-period of unstable angina pectoris

目的 :探讨辛伐他汀对不稳定型心绞痛 (UAP)发生早期 (2 4～ 96 h)开始应用的疗效及安全性。方法 :临床确诊为 UAP患者 89例 ,随机分为对照组 (常规治疗 ,4 5例 ) ,辛伐他汀组 (常规治疗外 ,加服辛伐他汀 ,4 4例 ) ,于治疗前、治疗后 3、6和 12个月时分别测肝功、肾功、肌酶谱、总胆固醇 (TC)、低密度脂蛋白胆固醇 (L DL - C)、一氧化氮(NO)、C-反应蛋白 (CRP)、高密度脂蛋白胆固醇 (HDL - C) ,2 4 h Holter检测心肌缺血总负荷 (TIB)和心血管缺血相关事件。结果 :辛伐他汀 6个月后能有效地降低 UAP患者血清 TC、L DL - C、CRP,升高 NO,HL D- C,与对照组比较有显著性差异 (P<0 .0 1) ;两组患者每周心绞痛发作次数及 TIB均有减少 ,但辛伐他汀组更明显 (P<0 .0 5 ) ;其缺血相关事件亦有显著性差异 (P<0 .0 1)。辛伐他汀组中有 4例轻度转氨酶升高 ,2例出现腹胀。结论 :U AP发病早期应用辛伐他汀能安全、有效地降低血脂和 CRP,升高 NO,显著减少心血管缺血相关事件发生率。

AIM: To explore the effect and safety of Simvastatin on patients with unstable angina pectoris (UAP) in early-period (24~96 h). METHODS: Eighty-nine patients with UAP were randomly divided into control group (with conventional drugs, n=45) and Simvastatin group (with conventional drugs and Simvastatin, n=44). It was tested myocardial enzymy, liver function, kidney function, total cholesterol (TC), Low-density lipoprotein cholesterol (LDL-C), Nitric oxide (NO), C-reactive protein (CRP), high-density lipoprotein cholesterol (HDL-C) and underwent total ischemic burden (TIB) monitoring from 24 hour ambulatory electrcardigram recording and observation of ischemia related events before and 3?6 and 12 months after therapy. RESULTS: The serum TC, LDL-C, CRP in Simvastatin group were obviously decrease than the control group after 6, 12 months of therapy (P<0.01), yet the serum NO, HDL-C were markly increased after 12-month treatment (P<0.05). After treatment, frequency of angina pectoris and TIB of both groups were decreased, but the Simvastatin group was further (P<0.05), so as of acute myocardial infarction (P<0.05). Four patients had slight elavation of ALT and 2 had abdominal distension in Simvastation group. CONCLUSION: Simvastatin is a effect and safety drug to take anti-myocardial ischemic and lipid-lowering, also can reduce the ischemia related events.