急性冠脉综合征患者短期大剂量瑞舒伐他汀治疗安全性和有效性的研究  

The Efficacy and Safety of Short Term Intensive Rosuvastatin Therapy in Acute Coronary Syndrome

作　　者：来蕾[1] 朱刚杰 王宁夫[1] 李虹[1] 童国新[1] 杨建敏[1] 叶显华[1] 周亮[1] 潘浩[1] 

机构地区：[1]浙江省杭州市第一人民医院,310006

出　　处：《心脑血管病防治》2014年第1期19-21,共3页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：目的探讨急性冠脉综合征(ACS)患者住院期间短期大剂量瑞舒伐他汀强化治疗的安全性和有效性。方法将急性冠脉综合征患者131例随机分为他汀强化组与常规组,强化组入院即给予瑞舒伐他汀20mg顿服,住院期间予瑞舒伐他汀20mg/晚口服;常规治疗组入院起予瑞舒伐他汀10mg/晚口服。强化组及常规组患者均于入院时及入院1周检测相关生化指标。结果治疗前两组患者年龄、性别、合并疾病、吸烟、肥胖情况及肌酐(Cr)、肌酸激酶(CK)、肾小球滤过率(GFR)比较差异无统计学意义(P>0.05),常规组谷丙转氨酶(ALT)水平高于强化组,差异有统计学意义(P<0.05)。治疗1周时,两组的ALT、AST均较前升高,差异有统计学意义(P<0.05)。但均值仍在正常范围内,两组间ALT,AST升高大于3倍的比例无显著差异;所有患者治疗前后Cr、CK、GFR水平比较差异无统计学意义(P>0.05)。治疗1周后,两组的甘油三脂(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)均较前明显下降,强化治疗组LDL-C水平下降更显著,差异均有统计学意义(P<0.01)。常规组治疗1周,HDL-C无明显改变,而强化组患者HDL-C水平明显升高,差异有统计学意义(P<0.01)。结论瑞舒伐他汀20mg短期强化治疗安全性与10mg相同,且能迅速有效降低患者胆固醇水平,提高高密度脂蛋白水平。Objective To evaluate the efficacy and safety of large doses intensive rosuvastatin treatment in short_term among the pa-tients with acute coronary syndrome （ACS ） during hospitalization.Methods A total of 131 ACS patients were enrolled into this study.They were randomly divided into the intensive group and conventional group.The patients in the intensive group were given 20mg ro-suvastatin as soon as admission ,20mg rosuvastatin every night during hospitalization.The patients in the general group were given 10mg every night during hospitalization.All the patients were given the biochemical indexes detection both on admission and after one week’s treatment.Results Age ,gender ,complications ,smoking ,overweight ,creatinine（Cr） ,creatine kinase（CK） ,and glomeru-larfiltrationrate（GFR）weresimilarbetweentwogroups （P〉0.05）.Levelsofbasicalanineaminotransferase （ALT）inconventional group were higher than that in intensive group.After one week’s treatment ,alanine aminotransferase （ALT） and aspartate amino-transferase （AST ） were higher in both groups ,which had a significantly difference than before （ P〈0.05 ） ,but still in normal range.Compared with 10mg group ,there was no significant increase in the proportion of 3_times increased in ALT ,and AST in 20mg group.No differences were found in CK ,Cr and GFR after one week’s therapy in both groups.After one week’s therapy ,blood total choles-terol ,triglycerides and LDL cholesterol were lower than before in both groups ,but LDL_C of intensive treatment were significantly lower than conventional treatment.HDL_C had no significantly differences in conventional group but significantly higher in the inten-sive group after one week’s treatment.Conclusions The 20mg short_term intensive rosuvastatin treatment is as safe as the 10mg gen-eral treatment ,and effectively reduce the lipid and cholesterol levels ,and increase the high density lipoprotein.

关 键 词：瑞舒伐他汀 急性冠脉综合征 血脂 

分 类 号：R541.4[医药卫生—心血管疾病] R972[医药卫生—内科学]