阿托伐他汀钙序贯治疗在ACS患者应用的安全性研究

目的探讨阿托伐他汀钙序贯治疗（患者均在经皮冠状动脉介入治疗术（PCI）前24h内给予阿托伐他汀钙80mg，再以每日40mg，维持1个月）在急性冠脉综合征（ACS）患者应用的安全性研究。方法选择滁州市第一人民医院收治的ACS患者120例，随机分为阿托伐他汀钙常规治疗组A组（20mg／d）和阿托伐他汀钙序贯组B组，收集两组临床资料，并监测人院用药前、用药后1、4、7、14、21、30天肝肾功能、肌酶指标。记录PCI术后30天内两组主要心血管不良事件（MACE）。结果两组用药后比较：ALT升高〈3倍正常值上限（ULN），A组12．50％和B组29．63％，差异有统计学意义（P=0．03），并且均发生在1周内；AIJT≥3ULN，A组3．57％和B组5．56％，差异无统计学意义（P=0．97）；碱性磷酸酶〉1ULN、总胆红索〉1ULN、肌酸激酶〉10ULN无明显变化，差异无统计学意义（P〉0．05）。两组主要MACE发生率，A组20．69％和B组7．27％，差异有统计学意义（P=0．04）。结论阿托伐他汀钙序贯治疗除早期存在一过性ALT轻度升高外，无其他严重不良反应的增加；阿托伐他汀序贯治疗减少主要MACE的发生。

Clinical Effect and Safety of Sequential Therapy of Atorvastatin on Acute Coronary Artery Syndrome Patient Undergoing PCI.

Objective To observe the clinical effect and safety of sequential therapy of atorvastatin on acute coronary artery syn- drome （ACS） patient undergoing percutaneous coronary intervention （ PCI）. Methods The clinical data of 120 consecutive patients with ACS who were treated in the first people＇s hospital of chuzhou were analyzed. All of the patients were enrolled into 2 groups. Group A re- ceived only post - PCI atorvastatin 20rag for 30 days and group B received 80 mg of atorvastatin before PCI, and post - PCI follow - up atorvastatin 40rag for 30days. Alanine aminotransferase （ALT） , alkaline phosphatase （ALP） , total bilirubin （TBL） , creatinine （Cr） , Cre- atine kinase （CK） were measured before administration and after 1,4,7,14,21,30days. 30 - day major adverse cardiac event （MACE） after PCI was monitored. Results After treatment,one times upper limit of normal （ULN） 〈 ALT elevation 〈 3 ULN 12.50% （A） and 29.63% （B） was found,and the difference was statistically signifieant（P =0.03）. ALT elevations〉3 ULN 3.57% （A） and 5.56% （B） was found, and the difference was not statistically significant（ P = 0.97 ）. ALP elevation 〉 1 ULN,TBL elevation 〉 1ULN, CK elevation 〉 10ULN were found, and the difference was not statistically significant （ P 〉 0.05 ）. MACE ,20.69% （A） and 7.72% （B） were found, and the difference was statistically significant （ P = 0.04）. Conclusion Sequential therapy of atorvastatin is safety in ACS patient. Atorvastatin sequential therapy can reduce the MACE in ACS patients 30days after PCI.