非高胆固醇血症急性冠脉综合征患者PCI术后他汀治疗临床观察

目的:观察非高胆固醇血症急性冠脉综合征(ACS)患者冠状动脉介入治疗(PCI)术后应用阿托伐他汀的效果.方法:111例血清胆固醇正常的ACS PCI术后患者,随机分为3组.3组均经抗血小板、抗凝和抗缺血治疗,同时对照组(38例)服安慰剂,不服调脂类药物;阿托伐他汀10 mg/d组(37例)和40 mg/d组(36例)分别服用阿托伐他汀10 mg/d和40 mg/d,每晚1次.除调脂药物外,不限制其他药物的使用.分别于术后6周、3个月、6个月、12个月复查血脂并观察心血管事件(心源性死亡、非致死性心梗死、复发性心绞痛)发生率及不良反应发生情况.结果:与对照组比较,阿托伐他汀组血清总胆固醇(TC)及低密度脂蛋白(LDL)水平均较低,且阿托伐他汀40mg/d组更低;综合心血管事件发生率亦降低(P均＜0.05).3组药物不良反应轻微,无肌溶解和严重肝功能损害.结论:非高胆固醇血症ACS患者PCI术后口服阿托伐他汀能减少术后1 a内心脏缺血事件的发生率,用药安全、副作用小.

Clinical study of atorvastatin in normal cholesterolemia patients with a cute coronary syndrome after PCI

Aim: To investigate the clinical efficiency and safety of atorvastatin in normal cholesterolemia patients with acute coronary syndrome(ACS) after percutaneous coronary intervention(PCI). Methods: A total of 111 cases were assigned into three groups randomly. Group A (n=38) was used as control, Group B (n=37) and Group C (n=36) were treated with atorvastatin 10 mg/d,40 mg/d,respectively. All cases were followed up for 12 months. The level of blood lipid was measured before treatment and 6 weeks, 3 months, 6 months and 12 months after treatment. Side effects and cardiac events were monitored. Results: Compared with those of Group A,the level of total cholsterole (TC ),low density lipoprotein (LDL) in Group B and C significantly decreased (P<0.05),and the effect of Group C was more significant; the occurrence of cardiac events such as recurred angina pectoris, fatal or nonfatal acute myocardial infarction, in Group B and C, were significantly lowered(P<0.05). The adverse reactions were similar and mild in all groups. Conclusion: Atorvastatin can safely decrease the occurrence of cardiac events in normal cholesterolemia patients with ACS after PCI.