阿托伐他汀在急性冠状动脉综合征患者早期应用的疗效分析  

Analysis on efficacy and safty of atorvastatin in early-period of acute coronary syndromes

作　　者：高智耀[1] 刘继保 李伟杰[3] 李亚军[1] 韩建仑[1] 

机构地区：[1]延安大学医学院第二附属医院心内科,陕西绥德718000 [2]榆林市第二人民医院急诊科,陕西榆林719000 [3]第四军医大学西京医院心内科,陕西西安710032

出　　处：《中国心血管杂志》2004年第4期271-274,共4页Chinese Journal of Cardiovascular Medicine

摘　　要：目的　探讨阿托伐他汀对急性冠状动脉综合征 (ACS)发生早期 (2 4～ 72 h)开始应用的疗效及安全性。方法　 10 7例临床确诊为 ACS患者随机分为对照组 (常规治疗 ,5 4例 ) ,阿托伐他汀组 (常规治疗外 ,加服阿托伐他汀 ,5 3例 ) ,于治疗前、治疗后 3、6和 12个月时分别测肝肾功能、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)、妊娠相关血浆蛋白 (PAPP- A)、高密度脂蛋白胆固醇 (HDL - C) ,统计心脑血管缺血相关事件。结果　阿托伐他汀治疗 12个月后能有效地降低 ACS患者血清 TC、L DL - C、CRP和PAPP- A,升高 NO及 HDL - 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均有减少 ,但阿托伐他汀组更明显 ,(P<0 .0 5 ) ;两组缺血相关事件亦有显著性差异 (P<0 .0 1)。阿托伐他汀组中有 6例轻度转氨酶升高 ,3例患者出现腹胀。结论　 ACS发病早期应用阿托伐他汀能安全、有效地降低血脂、PAPP- A和 CRP,升高 NO及 HDL- C显著减少心血管缺血相关事件发生率。Objective To explore the effect and safety of atorvastatin on patients with acute coronary syndromes(ACS) in early-period (24~72h). Methods 107 patients with ACS were randomly divided into control group (with conventional drugs, n=54) and atorvastatin group (with conventional drugs and atorvastatin, n=53). They were tested myocardial enzyme, liver function, kidney function, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), nitric oxide (NO), C-reactive protein (CRP), pregnancy associated plasma protein A(PAPP-A), high-density lipoprotein cholesterol (HDL-C), and were observed of ischemia related events before and 3,6 and 12 months after therapy. ResultsThe serum TC, LDL-C, CRP、PAPP-A in atorvastatin 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 of both groups were decreased but the atorvastatin group was further (P<0.05), so as of other cardiac events (P<0.05). 6 patients had slight elavation of ALT and 3 patients had abdominal distension in atorvastation group. ConclusionAtorvastatin is an effective and safe lipid-lowering drug ,it can decrease CRP,PAPP-A, and increase NO in plasma level, also can obviously reduce the ischemia related events.

关 键 词：急性冠状动脉综合征 血脂 阿托伐他汀 

分 类 号：R541.4[医药卫生—心血管疾病]