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目的 探讨急性冠状动脉综合征 (ACS)早期应用阿托伐他汀治疗的益处及安全性。方法 将 15 1例ACS病人随机单盲分为两组。治疗组 76例 ,每日给予阿托伐他汀 (10～2 0 )mg。对照组 75例 ,安慰剂每日 1粒。随访 1年 ,观察两组住院期及随访期心脑血管事件、调降脂效果及药物不良反应。结果 治疗组用阿托伐他汀治疗 6周和 1年 ,均显著降低血总胆固醇 (TC)、三酰甘油 (TG)、低密度脂蛋白胆固醇 (LDL)、载脂蛋白B(ApoB)水平 ,升高高密度脂蛋白胆固醇 (HDL )、载脂蛋白A1(ApoA1) (P均 <0 .0 1)。且与对照组相比 ,有统计学意义 (P <0 .0 1)。治疗组住院期反复心绞痛发作、心力衰竭 (HF)、心律失常发生危险明显较对照组减少(P <0 .0 5 )。随访期复发性心绞痛、非致死性心肌梗死、HF、需做经皮腔内冠脉成形术 /冠脉旁路移植术 (PT CA/CABG)、因缺血发作需再住院治疗和心律失常发生明显比对照组减少(P <0 .0 5 )。同时 ,阿托伐他汀治疗 6周后 ,血纤溶酶原激活物抑制剂 -1(PAI -1)、纤维蛋白原 (FG)、D -二聚体、C -反应蛋白 (CRP)较治疗前明显降低 (P <0 .0 1) ,且与对照组有统计学意义 (P <0 .0 1)。同时ACS早期应用阿托伐他汀不良反应轻微 ,与对照组相似。结论 ACS早期应用阿托伐他汀治疗有效、安全 ,可减少住?
Objective To investigate the benefits and safety of early atorvastatin in patients with acute coronary syndrome (ACS). Methods 15 1 ACS patients were randomly divided into two groups. In the treatment group, 76 cases were given daily atorvastatin (10 ~ 20) mg. Control group, 75 cases, placebo one day. Followed up for 1 year, observed two groups of hospitalization and follow-up of cardiovascular events, lipid-lowering effect and adverse drug reactions. Results Atorvastatin treatment for 6 weeks and 1 year in treatment group significantly decreased the levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL) and apolipoprotein B (ApoB) Elevated high-density lipoprotein cholesterol (HDL), apolipoprotein A1 (ApoA1) (P <0.01). Compared with the control group, there was statistical significance (P <0.01). In the treatment group, the incidence of recurrent angina pectoris in hospitalized patients was significantly lower than that in the control group (P <0.05). The risk of heart failure (HF) and arrhythmia were significantly decreased. Follow-up recurrent angina pectoris, non-fatal myocardial infarction, HF require percutaneous transluminal coronary angioplasty / coronary artery bypass grafting (PT CA / CABG), rehospitalization due to an ischemic attack and arrhythmia Significantly lower than the control group (P <0. 05). At the same time, plasminogen activator inhibitor - 1 (PAI - 1), fibrinogen (FG), D - dimer and C - reactive protein (CRP) (P <0.01), which was significantly lower than that of the control group (P <0.01). ACS at the same time early application of atorvastatin mild side effects, similar to the control group. Conclusions The early use of atorvastatin in ACS is effective and safe and can reduce the burden of stay.