论文部分内容阅读
目的:观察老年急性冠状动脉综合征(ACS)发病早期应用不同剂量的辛伐他汀的临床疗效及安全性。方法:选择临床确诊为ACS的患者共117例,均总胆固醇(TC)≥4.68mmol/L和(或)低密度脂蛋白胆固醇(LDLC)≥2.6mmol/L,年龄62～79岁。入院48h内空腹采静脉血测定血脂等生化指标及高敏C反应蛋白(hsCRP),将患者随机分为20mg组(A组,58例)和40mg组(B组,59例),均为每晚服药1次,分别于用药前,用药后4、12周测定TC、LDLC、高密度脂蛋白胆固醇、三酰甘油及hsCRP,随访3个月内所有不良反应,观察终点为心脏事件的发生率。结果:①2组服药后4、12周的TC、LDLC、hsCRP水平均较治疗前明显降低(P<0.05),B组较A组降低更明显,P<0.05;②B组累计心脏事件发生率较A组明显减少(P<0.05);③2组均无严重不良反应。结论:ACS患者早期应用辛伐他汀40mg/d,能更有效地降脂,提高达标率,明显抑制炎症因子,减少住院率及心脏血管事件的发生率,且安全、耐受性好。
Objective: To observe the clinical efficacy and safety of different doses of simvastatin in elderly patients with acute coronary syndrome (ACS). Methods: A total of 117 patients with clinically diagnosed ACS were enrolled in this study. The total cholesterol (TC) ≥4.68mmol / L and / or LDLC≥2.6mmol / L, age ranged from 62 to 79 years old. Fasting blood samples were collected for blood biochemical markers and hsCRP within 48 h after admission. The patients were randomly divided into 20 mg group (A group, 58 cases) and 40 mg group (B group, 59 cases) The patients were given medicine once, and TC, LDLC, HDL-C, triglyceride and hsCRP were measured before medication and 4 and 12 weeks after treatment. All the adverse reactions were followed up for 3 months. The end point was the incidence of cardiac events. Results: ① The levels of TC, LDLC and hsCRP in group 2 and group D were significantly lower than those before treatment at 4 and 12 weeks (P <0.05), and those in group B were significantly lower than those in group A (P <0.05). ② The cumulative incidence of cardiac events A group was significantly reduced (P <0.05); ③ 2 groups were no serious adverse reactions. Conclusion: The early application of simvastatin 40mg / d in patients with ACS can be more effective lipid-lowering and improve the compliance rate, significantly inhibit the inflammatory factors, reduce the incidence of hospitalizations and cardiovascular events, and safety and tolerability.