不同剂量他汀治疗急性冠脉综合征患者急性期疗效观察  

Clinical efficacy of different doses of statins in acute coronary syndrome patients at acute phase

作　　者：粟治洲 吕建峰[1] 刘波[1] 迟路湘[1] 

机构地区：[1]第三军医大学西南医院心血管内科,重庆市介入心脏病学研究所,重庆400038

出　　处：《第三军医大学学报》2015年第1期60-63,共4页Journal of Third Military Medical University

摘　　要：目的观察不同剂量他汀治疗急性冠脉综合征（acute coronary syndrome,ACS）患者急性期的疗效。方法回顾性分析我科2012年1月至2014年6月住院治疗的ACS患者133例（男性110例,女性23例）,分为4组：治疗应用瑞舒伐他汀10 mg/d 32例（A组）,瑞舒伐他汀20 mg/d 37例（B组）,阿托伐他汀20 mg/d 33例（C组）,阿托伐他汀40 mg/d 31例（D组）。比较、分析治疗6~8周后各组总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、非高密度脂蛋白胆固醇（non-HDL-C）的变化以及不良反应。结果治疗前各组患者基线指标差异无统计学意义（P〉0.05）;治疗6~8周后,各组TC、LDL-C、non-HDL水平均较治疗前显著下降（P〈0.01）,各组间治疗前后LDL-C改变量（△LDL-C）和non-HDL-C改变量（△non-HDL-C）,B组和D组显著高于A组和C组（P〈0.01）,但B组和D组之间差异无统计学意义（P〉0.05）。B组在治疗期间发生1例谷丙转氨酶（ALT）明显升高,由33 U/L升高至1 120 U/L,其他3组均无不良反应报告。结论对ACS患者急性期应用大剂量他汀（瑞舒伐他汀20 mg/d和阿托伐他汀40 mg/d）较常规剂量他汀（瑞舒伐他汀10 mg/d和阿托伐他汀20 mg/d）降脂疗效更佳,且均具有用药安全性。Objective To observe the efficacy of different doses of statin in acute coronary syndrome （ACS） patients at acute phase. Methods Clinical data of 133 ACS patients （110 males and 23 females） hospitalized in our department from January 2012 to June 2014 were collected and retrospectively analyzed. These patients were divided into 4 groups, that is, group A （treated with rosuvastatin of 10 mg/d, n = 32）, group B （20 mg/d rosuvastatin, n = 37 ）, group C （20 mg/d atorvastatin, n = 33 ）, and group D （40 mg/d atorvastatin, n = 31 ）. The serum levels of total cholesterol （TC）, low-density lipoprotein cholesterol （ LDL-C）, high density lipoprotein cholesterol （HDL-C）, and non-high-density lipoprotein cholesterol （non-HDL-C）, and the incidences of adverse reactions were compared in each group before and in 6 to 8 weeks after the treatment, and among different groups. Results Before the treatment, there was no significant difference in the baseline data among the 4 groups （P 〉 0.05）. After 6 to 8 weeks＇ treatment, the serum levels of TC, LDL-C and non-HDL-C were dropped significantly in all groups （ P 〈 0.01 ）. After treatment, the level of A LDL-C and A non-HDL-C （the changes before and after the treatment） were significantly larger in groups B and D than groups A and C （ P 〈 0.01 ）, but there was no significant difference in the 2 indexes between group B and group D （ P 〉 0.05 ）. During the treatment, only 1 patient from group B had significant increase in ALT, from 33 to 1120 U/L. And there was no report High-dose statin （rosuvastatin 20 mg/d and atorvastatin statin （rosuvastatin 10 mg/d and atorvastatin 20 mg/d） of adverse reactions in other groups. Conclusion 40 mg/d）treatment is superior to conventional-dose on the patients at acute ohase of ACS. and has good safety at the same time.

关 键 词：急性冠状动脉综合征 不同剂量 他汀类药物 胆固醇 

分 类 号：R543.305[医药卫生—心血管疾病] R969.4[医药卫生—内科学]