急性冠脉综合症中不同剂量辛伐他汀对纤溶系统和血小板活性的影响.docVIP

急性冠脉综合症中不同剂量辛伐他汀对纤溶系统和血小板活性的影响 郑伟，吴江平 (广东省中山市三乡医院ICU,广东中山 528463） 【摘要】 目的 探讨不同剂量辛伐他汀在急性冠脉综合症（ACS））14天时对纤溶和血小板活性的影响有显著的差别，效果依次为60mg组，40mg组，20mg组，在30天时各组较14天时比较仍有统计学的差异，但差距明显缩小,同时在40mg及60mg组间的差距也明显减少，显示有一定的时间剂量关系。结论 对ACS患者，应在14天以前可以予以较大剂量的60mg服用，在尽快的稳定粥样斑块后，可以继以中等剂量的40mg长期服用。 关键词 急性冠脉综合症;辛伐他汀;纤溶系统;血小板活性 中图分类号:R541.4　 文献标识码:A Effects of Different Doses of Simvastatin in Acute Coronary Syndrome Patients on Fibrinolytic system and Platelet Activaty Zhengwei (Department of ICU,Sanxiang Hospital of Zhongshan City,Guangdong Province,Zhonshan 528463，China) 【 Abstract】 Objective To investigate the effect of different doses of simvastatin in patients with acute coronary syndrome (ACS) on fibrinolytic system and platelet activaty. Methods On the basis of conventional treatment, simvastatin granted 20mg/d, 40mg/d and 60mg/d, respectively. on the day of admission, 14th day, and 30th day, elbow venous blood of fasting are extracted for assay of total cholesterol (TC), low density lipoprotein (LDL-C), ALT (ALT) and aspartate aminotransferase (AST), creatine muscle enzymes (CK), plasma and tissue-type plasminogen activator (t-PA) and plasma tissue-type plasminogen activator inhibitor (PAI-1), thromboxane B2 (TXB2), platelet particles membrane protein-140 (GMP140).Observed the impact of different doses of simvastatin. Results Different dose simvastatin in 14th day demonstrated significant differences on fibrinolytic and platelet activation.In the 30th day,there are still significant differences compare with 14th day,but the gaps between three groups decreased significantly. While in Group 40mg and 60mg,the gaps also decreased significantly, show that there are certain time dose relationship. Conclusions On ACS patients, a larger dose of the medication of 60mg Simvastatin before 14 days should be administrated as soon as possible, moderate dosage can be followed by long-term use of 40mg. Keywords：Acute coronary syndrome; Simvastatin; Fi