阿托伐他汀在急性冠脉综合征血脂正常患者中的早期应用

目的:观察阿托伐他汀对血脂正常急性冠状动脉综合征(ACS)患者早期炎症因子和心脑血管事件的干预效果。方法:122例血脂正常的ACS患者随机分为阿托伐他汀治疗组和常规治疗对照组(各61例),另选择同期40例健康者作为健康对照组,分析比较组间及阿托伐他汀治疗(10mg/日×6月)前和治疗后2、4周血清白介素-6(IL-6)、高敏C反应蛋白(hs-CRP)和血脂水平的变化,同时观察ACS患者住院和半年随访期间主要心脑血管事件发生情况。结果:两组ACS患者血脂水平与健康对照组无显著差别,但其IL-6和hs-CRP水平显著高于健康对照组(P均<0.01);阿托伐他汀治疗2周后,仅IL-6、hs-CRP显著降低(P均<0.01),治疗4周后血胆固醇(TC)、低密度脂蛋白-胆固醇(LDL-C)及IL-6、hs-CRP均显著降低(P均<0.01)且均低于常规治疗对照组(P均<0.05);阿托伐他汀治疗组住院期间复发性心绞痛、心力衰竭、心律失常及半年随访期间复发性心绞痛、非致死性心肌梗塞、心力衰竭、心律失常、需再住院治疗等均较常规治疗组显著降低(P均<0.05)。结论:血脂正常的ACS患者存在炎症反应,阿托伐他汀早期治疗能够抑制炎症因子,降低住院期间和半年随访期间主要心血管事件发生率。

Effect of atorvastatin in patients of acute coronary syndrome with normal lipid level in early stage

Objective:To study the effect of atorvastatin on inflammatory factors and cardiovascular events in patients of acute coronary syndrome (ACS) with normal lipid level in early stage.Methods:The 122 ACS patients were divided into routine treatment control group (n=61) and treatment group(n=61)with added atorvastatin 10 mg per day within 48 h from onset.The 40 healthy subjects were selected as normal control group.The level of interleukin-6 (IL-6) and high sensitive C-reaction protein (hs-CRP) were measured before and after two and four weeks treatment.Results:The lipid levels in two ACS groups were similar to normal control group, but its level of IL-6 and hs-CRP were all significantly higher than those of normal control group (P<0.01).After two weeks treatment with atorvastatin,the level of IL-6 and hs-CRP were all decreased significantly than pre-treatment(P<0.01);After four weeks treatment, total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),IL-6 and hs-CRP were all lowered significantly(P<0.01) and its level were also all lower than those of routine treatment control group (P<0.05).Comparing with routine treatment control group, there were relatively lower recurrent angina pectoris, congestive heart failure and arrhypthmia in treatment group during hospitalization (P<0.05).The above index and non-fatal myocardial infarction,re-hospitalization in treatment group during the 6 months follow up were also less than those of control group(P<0.05).Conclusion:The inflammation may exist in patients of ACS with normal lipid level. Early treatment with atorvastatin can significantly inhibit inflammatory factors and decrease the incidence of cardiovascular events during hospitalization and 6 months follow up.