两种剂量洛伐他汀在急性冠状动脉综合征早期应用的临床研究

目的探讨急性冠状动脉综合征(ACS)早期应用40mg/d洛伐他汀的有效性、达标率、抗炎和安全性。方法将153例ACS患者分为洛伐他汀40mg/d组(77例)和10mg/d组(76例)两组,随访半年,观察调脂疗效、达标率、抗炎及药物不良反应。结果洛伐他汀40mg组和10mg组,治疗6周和半年,均能显著降低血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(apoB)水平(P<0.01),升高高密度脂蛋胆固醇(HDL-C)、载脂蛋白Al(apoAl)水平(P<0.05)。40mg组在治疗6周和半年后的总达标率、TC达标率、LDL-C达标率优于10mg组(P均<0.05)。两组治疗6周后,纤维蛋白原(FG)、C-反应蛋白(CRP)、D-二聚体均较治疗前明显降低(P<0.01)。而40mg组对降低上述3种炎症物作用优于10mg组(P<0.05)。两组患者服药后不良反应轻微。结论ACS早期应用40mg/d洛伐他汀治疗,能有效调降脂、提高达标率、明显抑制炎症因子。

The study of different doses lovastatin in patients of acute coronary syndrome in early stage

Objective To investigate the safety and efficacy of two different doses lovastatin in patients of acute coronary syndrome(ACS) in early stage. Methods 153 consecutive patients with ACS were divided into two groups randomly;group 1(n=77) was given 40mg/d lovastatin at night,group(2=76) was given 10mg/d lovastatin. The efficacy of lovastatin therapy,drug adverse reaction were recorded in 6 month follow up.Results Compared with those before treatment, the total plasma cholesterol,triglyceride,low density lipoprotein, aplipoprotein B,heightening high desisity lipoprotein and apolipoprotein A decreased significantly at 6 week and 6 month after treatment in both groups(P<0.05).There was significant difference in the two groups after treatment(P<0.05).According to China Heart Association Suggestion:Abnormal of blood-lipid in prevention and treatment, Group 1 was better than group 2 in reaching to target blood-lipid goal level on total cholesterol and lower density lipoprotein(P<0.05).There were significantly different in fibrinogen, C-creatin protein and plasma D-dimer in the two groups after 6 weeks treatment(P<0.01).The drug adverse reaction was mild and similar in two groups. Conclusions The use of 40mg/d lovastatin seems safety and efficacy in heightening target blood-lipid goal rate,inhibiting inflammation factor.The early use of lovastatin 40mg/d will be good in safety, efficacy and tolerance.