阿托伐他汀强化治疗对急性冠脉综合征患者TXA2、PGI2的早期影响  

Early effects of atorvastatin intensive treatment on levels of TXA2 and PGI 2 in patients with acute coronary syndrome

作　　者：周齐艳[1] 余国龙[2] 卿丽琼[2] 

机构地区：[1]永州职业技术学院医学院,湖南永州425006 [2]中南大学湘雅医院心内科,湖南长沙410008

出　　处：《中国现代医学杂志》2010年第13期2058-2061,共4页China Journal of Modern Medicine

摘　　要：目的该研究观察阿托伐他汀强化治疗对急性冠脉综合征(ACS)患者血浆血栓素A2(Thromboxan A2;TXA2)、前列环素(Prostacyclin PGI2)浓度的早期影响。方法 46例确诊为ACS患者入院后24h内在接受常规治疗(包括溶栓剂、抗凝剂、ACEI、β受体阻滞剂、钙通道拮抗剂及硝酸酯类等)基础上随机分为:常规治疗组(阿托伐他汀20mg,1次/晚)、强化治疗组(阿托伐他汀40mg,1次/晚)。分别于治疗前及治疗5d后测量患者血浆TXA2、PGI2及血脂水平。另选取健康正常人23例为对照组。结果结果显示,ACS患者血浆TXA2水平显著高于对照组,PGI2显著低于对照组水平;治疗后两组患者血浆TXA2均下降,血浆PGI2均增高,且强化治疗组治疗后血浆TXA2、PGI2水平与常规治疗组比较有显著统计学意义;治疗两组患者各血脂成分有下降/增高趋势,但与治疗前浓度比较均无统计学意义;直线相关分析显示,两组ACS患者治疗前、后TXA2、PGI2水平与血脂各成分浓度均无相关性。结论该研究结果提示,ACS患者存在血小板过度激活;阿托伐他汀强化较常规治疗能显著降低ACS患者血浆TXA2和增高PGI2水平;阿托伐他汀对TXA2和PGI2影响不依赖于血脂的改变。[Objective ] To observe the early efficacy of atorvastatin intensive treatment on levels of TXA2.PGI2 in patients with acute coronary syndrome（ACS）. [Methods] 46 patients with acute coronary syndrome （ACS） were randomly divided into two groups, on the basis of receiving regular treatment within 24 hours after admitted, conventional therapy group （atorvastatin 20mg QN） and the enhanced treatment group （atorvastatin 40mg QN）. 23 healthy subjects were assigned to control group. Before and after five days treatment, the levels of plasma TXA2.PGI2 and blood lipid were analyzed. [ Results ] The results demonstrated that the level of plasma TXA2 was obviously higher in ACS patients than that in control group, and the PGI2 level obviously lowered in ACS patients than that in the control group. After the treatment, the TXA2 level was decreased significantly and the PGI2 level was obviously increased in the both groups, and the changes were more obvious in the enhanced treatment group. There were no differences in the levels of TC, TG, LDL between before and after treatment in the both groups. Linear correlation analysis showed the levels of TXA2, PGI2 had no significant correlation with the blood TC, TG, LDL, HDL in ACS patients of both groups before and after treatment. [ Conclusion ] The results suggested that the atorvastatin enhanced treatment results in a further decrease of TXA2 and increase of PGI2 in ACS patients compared to regular treatment. Moreover, this efficacy is not related to blood lipids changes induced by atorvastatin.

关 键 词：急性冠脉综合征 血栓素A2 前列环素 阿托伐他汀 

分 类 号：R543.3[医药卫生—心血管疾病]