急诊强化他汀治疗在急性冠脉综合征患者中的应用 - 内科急危重症杂志.doc

急诊大剂量阿托伐他汀治疗在急性冠脉综合征患者中的应用效果观察 马健 张勇*1 田彩霞2 （1湖北医药学院附属东风医院 湖北十堰 442000；2湖北医药学院 湖北十堰 442000） 【摘要】:目的:探讨大剂量阿托伐他汀降脂应用于急性冠脉综合征(ACS)患者的治疗效果。方法：选取我院2009年1月-2013年1月间收治的ACS患者70例，将其随机分为强化组以及对照组。两组患者均予以阿司匹林、低分子肝素、硝酸酯类、β-受体阻滞剂以及血管紧张素转换酶抑制剂等常规治疗。强化组患者在此基础上加用阿托伐他汀20mg*qn，连续治疗8周。对照组患者在此基础上加用阿托伐他汀10mg*qn，连续治疗8周。比较两组患者治疗前及治疗8周后的血清hs-CRP、IL-10以及MMP-9的变化情况，并观察治疗不良反应。结果：两组治疗前血清hs-CRP、IL-10和MMP-9水平比较无明显差异（P0.05）。治疗8周后，两组血清hs-CRP和MMP-9水平均较前明显下降，血清IL-10水平较前明显上升（t＝2.44、2.27、2.46、3.05、2.91、2.92，P0.05或P0.01），且强化组下降或上升值较对照组更明显（t＝3.27、3.31、6.11，均P0.05）。强化组治疗有效率为88.6%（31/35）,对照组为68.6%（24/35）,组间比较差异有统计学意义，(X2=4.16,P0.05)。两组患者均未发生严重的不良反应。结论:急诊大剂量阿托伐他汀降脂治疗应用于ACS的治疗具有较好的效果，能降低血清hs-CRP和MMP-9水平，提高血清IL-10水平，且药物的安全性好。 【关键词】：阿托伐他汀；ACS；安全性；临床效果 Observed the effect of using emergency high-dose of atorvastatin therapy in acute coronary syndrome patients 【Abstract】: Objective: Observed the effect of using emergency high-dose of atorvastatin therapy in acute coronary syndrome patients. Methods: Selected 70 cases of patients with acute coronary syndrome (ACS) from January 2009 to January 2009 , randomly divided them into strengthening group and the control group. Two groups of patients both received aspirin and heparin, nitrate, beta blockers and angiotensin converting enzyme inhibitors for conventional treatment. The strengthen group used atorvastatin 20 mg * qn, continuous treatment of 8 weeks on the basis of it.the control group patients combined with atorvastatin 10 mg * qn, continuous treatment of 8 weeks on the basis of it. Compare serum hs-CRP, IL-10 and the change of MMP-9 in two groups of patients before and after 8 weeks treatment ,and observed the treatment adverse reactions in two groups. Results: Before treatment hs-CRP, IL-10 and the level of MMP-9 levels in two groups had no significant difference (P 0.05). 8 weeks after treatment, hs-serum CRP and the level of MMP-9 levels in two groups was markedly reduced, and significant increase in serum levels of IL-10(t = 2.44, 2.27, 2.46, 3.05, 2.91,