早期负荷剂量阿托伐他汀治疗血脂正常的急性非 ST 段抬高型心肌梗死疗效观察

目的：探讨早期应用负荷剂量阿托伐他汀对血脂正常的急性非ST段抬高型心肌梗死（ non-ST-segment elevation acut myocardial infarction ，NSTEMI）患者的临床疗效及安全性。方法将血脂正常的NSTEMI患者65例，随机分为阿托伐他汀负荷剂量组（A组）33例及常规剂量组（B组）32例，A组给予阿托伐他汀钙片40 mg/d，口服；B组给予阿托伐他汀钙片20 mg/d，口服。分别于治疗前及治疗2周后测定血脂、高敏C-反应蛋白（ high-sensitivity C-reactive protein ，hs-CRP）、血清脂联素（ adiponectin ， APN）、肝功能，并且随访6个月，统计严重心血管不良事件（ major adverse cardiovascular events ，MACE）发生情况。结果与常规剂量组比较，负荷剂量组的总胆固醇（total cholesterol，TCH）、低密度脂蛋白胆固醇（low density lipoprotein cholesterol，LDL-C）、hs-CRP下降更明显，APN较高，且两组肝功能无明显损害。6个月随访，负荷剂量组的MACE发生率少于常规剂量组。结论血脂正常的NSTEMI患者早期应用负荷剂量阿托伐他汀钙片可使炎性反应明显减轻，稳定粥样斑块，并且改善预后。

Early application of load dose of atorvastation to patients with non-ST-segment elevation acute myocardial infarction with nornal lipids

Objective To ivsetigate the clinical effect and safety of early application of load dose of atorvastation to patients with non-ST-segment elevation acute myocardial infarction with nornal lipids .Methods A total of 65 patients who were diagnosed as having NSTEMI with nornal lipids were randomly divided into atorvastation load dose group （ group A, n=33） and the conventional dose group （group B, n=32）.Group A took 40 mg/d atorvastation in addition to routine treatment .Group B took 20 mg/d atorvasta-tion.Blood lipids, high-sensitivity C-reactive protein（hs-CRP）and adiponectin（APN） levels, and liver functions were measured before treatment and after 2 weeks of treatment.Patients were followed up for 6 months.The incidence of major adverse cardiovascular events （MACE） were observed.Results The TCH,LDL-C and hs-CRP levels were decreased more obviously in group A after 2 weeks treat-ment （P＆lt;0.05）.while the APN levels were increased more obviously in group A （P＆lt;0.05）.Obvious liver dysfunctions were not found in both groups .After 6 months,the incidence of MACE was lower in group A than in group B .Conclusions In patients with NSTEMI, even with normal blood lipids ,taking load dose of atorvastation early can reduce the inflammation response , improve the sta-bilization of atherosclerotic plaque and improve the prognosis .