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目的 :研究两组不同剂量辛伐他汀治疗急性冠状动脉综合征 (ACS)的近期心血管事件影响及安全性。方法 :15 2例ACS患者随机分成 3组。A组常规治疗 ;B组 :辛伐他汀 2 0mg/d ;C组 :辛伐他汀 4 0mg/d ,随访观察 3组患者首次入院后 1个月和 1年的终点事件发生率 (死亡、再发心绞痛或心肌梗死、再入院率 )以及血脂水平、肝肾功能和不良反应。结果 :B组、C组初始 1个月及 1年内的病死率、再发心绞痛、再发心肌梗死及再住院率均较A组明显降低 (均P <0 .0 5 )。B组 1个月、1年病死率下降分别为 3.92 %、7.84 % ,C组 1个月、1年病死率下降分别为 3.76 %、7.6 0 % ;C组与B组比较 ,初始 1个月内心绞痛、心肌梗死再发生率差异有统计学意义 (P<0 .0 5 )。但对 1年内病死率及心绞痛、心肌梗死的再发生率差异无统计学意义 (均P >0 .0 5 )。 2、6、12个月血脂监测显示B组、C组均能有效降低总胆固醇、低密度脂蛋白胆固醇、三酰甘油水平。B组 2例、C组 3例出现恶心、纳差等消化道症状 ;B组 1例、C组 2例出现转氨酶增高 1～ 3倍。结论 :辛伐他汀 2 0、4 0mg用于ACS早期治疗均安全有效 ,均能有效降低近期冠心病事件发生率和病死率 ,且提示疗效与剂量成正相关
Objective: To investigate the recent cardiovascular events and safety of two groups of different doses of simvastatin in the treatment of acute coronary syndrome (ACS). Methods Fifty-two ACS patients were randomly divided into three groups. Group B: simvastatin 20 mg / d; group C: simvastatin 40 mg / d. The incidence of end-point events at 1 month and 1 year after the first admission was observed Angina or myocardial infarction, readmission rate), and blood lipid levels, liver and kidney function and adverse reactions. Results: The mortality, recurrence of angina pectoris, recurrent myocardial infarction and rehospitalization rate in group B and group C were significantly lower than those in group A at the first month and one year (both P <0.05). In group B, the 1-month and 1-year mortality rates were 3.92% and 7.84% respectively. The 1-year and 1-year mortality rates in group C were 3.76% and 7.6% respectively. In group C and B, the first month Angina and myocardial infarction recurrence rates were significantly different (P <0.05). However, there was no significant difference in the incidence of recurrence between 1-year mortality and angina pectoris and myocardial infarction (all P> 0.05). At 2, 6 and 12 months, blood lipid monitoring showed that both B and C groups could effectively reduce the levels of total cholesterol, low density lipoprotein cholesterol and triglyceride. B group 2 cases, C group 3 cases of nausea, anorexia and other gastrointestinal symptoms; B group 1 cases, C group 2 cases appeared transaminase increased 1 to 3 times. CONCLUSIONS: Simvastatin 20 0,4 0 mg is safe and effective for the early treatment of ACS, both of which can effectively reduce the incidence of coronary heart disease and mortality in recent years, and suggest that the effect is dose-dependently