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目的探讨40 mg/d阿托伐他汀对急性冠状动脉综合征行经皮冠状动脉介入治疗术后患者的调脂及抗炎作用。方法将92例急性冠状动脉综合征行经皮冠状动脉介入治疗术后患者随机均分为两组,对照组给予阿托伐他汀10 mg/d,试验组给予阿托伐他汀40 mg/d,用药后4、12、24周检测两组患者血脂、血清中超敏C反应蛋白和基质金属蛋白酶9浓度,对比两组调脂及抗炎作用差异。结果①用药后12周,试验组患者血清总胆固醇较对照组显著降低(P<0.05);用药后24周,试验组患者血清总胆固醇和低密度脂蛋白胆固醇均较对照组显著降低(P<0.01)。②用药后12周,试验组患者血清基质金属蛋白酶9较对照组显著降低(P<0.01);用药后24周,试验组患者血清超敏C反应蛋白较对照组显著降低(P<0.05)。③降脂强度与病人的血清超敏C反应蛋白和基质金属蛋白酶9的浓度下降趋势呈线性正相关。④随访期内两组心脏事件发生率无统计学差异(P>0.05)。结论①服用阿托伐他汀40 mg/d安全可靠。②服用阿托伐他汀40 mg/d可显著提高急性冠状动脉综合征患者行经皮冠状动脉介入治疗术后血脂达标率。③服用阿托伐他汀40 mg/d对炎症因子血清基质金属蛋白酶9和血清超敏C反应蛋白具有更强抑制作用。
Objective To investigate the lipid-lowering and anti-inflammatory effects of 40 mg / day atorvastatin on patients with acute coronary syndrome undergoing percutaneous coronary intervention. Methods 92 patients with acute coronary syndrome undergoing percutaneous coronary intervention were randomly divided into two groups. The control group was given atorvastatin 10 mg / d, the experimental group was given atorvastatin 40 mg / d, The levels of serum lipids, serum high-sensitivity C-reactive protein (MMP-9) and matrix metalloproteinase 9 (MMP-9) were detected at 4, 12, and 24 weeks after treatment. Results ① At 12 weeks after treatment, serum total cholesterol in test group was significantly lower than that in control group (P <0.05). At 24 weeks after treatment, serum total cholesterol and LDL cholesterol in test group were significantly lower than those in control group (P < 0.01). ② At 12 weeks after treatment, serum MMP-9 level in the test group was significantly lower than that in the control group (P <0.01). Serum high-sensitivity C-reactive protein in the test group was significantly lower than that in the control group at 24 weeks after treatment (P <0.05). ③ lipid-lowering intensity and the patient’s serum hs-CRP and matrix metalloproteinase-9 concentration decreased linearly positive correlation. ④ There was no significant difference in the incidence of cardiac events between the two groups during follow-up (P> 0.05). Conclusion ① Atorvastatin 40 mg / d is safe and reliable. ② Atorvastatin 40 mg / d can significantly improve the blood lipid compliance after percutaneous coronary intervention in patients with acute coronary syndrome. ③ Atorvastatin 40 mg / d had a stronger inhibitory effect on inflammatory cytokines, serum matrix metalloproteinase-9 and serum high-sensitivity C-reactive protein.