早期强化辛伐他汀治疗急性冠状动脉综合征的研究

目的 :研究两组不同剂量辛伐他汀治疗急性冠状动脉综合征 (ACS)的近期心血管事件影响及安全性。方法 :15 2例ACS患者随机分成 3组。A组常规治疗 ;B组 :辛伐他汀 2 0mg/d ;C组 :辛伐他汀 4 0mg/d ,随访观察 3组患者首次入院后 1个月和 1年的终点事件发生率 (死亡、再发心绞痛或心肌梗死、再入院率 )以及血脂水平、肝肾功能和不良反应。结果 :B组、C组初始 1个月及 1年内的病死率、再发心绞痛、再发心肌梗死及再住院率均较A组明显降低 (均P <0 .0 5 )。B组 1个月、1年病死率下降分别为 3.92 %、7.84 % ,C组 1个月、1年病死率下降分别为 3.76 %、7.6 0 % ;C组与B组比较 ,初始 1个月内心绞痛、心肌梗死再发生率差异有统计学意义 (P<0 .0 5 )。但对 1年内病死率及心绞痛、心肌梗死的再发生率差异无统计学意义 (均P >0 .0 5 )。 2、6、12个月血脂监测显示B组、C组均能有效降低总胆固醇、低密度脂蛋白胆固醇、三酰甘油水平。B组 2例、C组 3例出现恶心、纳差等消化道症状 ;B组 1例、C组 2例出现转氨酶增高 1～ 3倍。结论 :辛伐他汀 2 0、4 0mg用于ACS早期治疗均安全有效 ,均能有效降低近期冠心病事件发生率和病死率 ,且提示疗效与剂量成正相关

Value of early using simvastatin in patients with acute coronary syndrome

Objective:To study whether the treatment of two different fortified dosage of Simvastatin in patients with acute coronary syndrome(ACS) is safe and may decrease the risk of major events in early period.Methord:One hundred and fifty-two patients with ACS, each of total cholesterol(TC) was over 4.68 mmol/L and low-densty lipoprotein cholesterol (LDL-C) over 2.6 mmol/L, were divided into three groups in random. Group A was control group ( n=51 ), Group B treated with Simvastatin 20 mg/d (n=51 ). Group C treated with Simvastatin 40 mg/d (n=50 ). The rate of eventual events ( angina, myocaridial infarction, re-hospitalization ), the level of serum lipid, the function of liver and renal and the reaction of adverse offects were surveyed during the period of one month and one year later. Result:During the period of one month and one year later, the rate of coronary disease events was decreased obviously in group B and C compared with group A (P< 0.05). The mortality of group B decreased 3.92% and 7.84%. In one month and one year later compared with group A. The mortality of group C decreased 3.76% and 7.60% in one month and one year later. Group C compared with group B, the rate of angina and myocardial decreased (P< 0.05 ). But the mortality had no significent difference between group B and C. The serum lipid also decreased obviously in group B and C after treatment. A few cases have the symptom of digestive system such as nausea and a few cases have the increased level of serum transaminase. They all come to normal level after decreasing dosage or creasing treatment. Conclusion:The treatment of Simvastatin 20 mg/d,40 mg/d to patients with early period of ACS is efficiency and safe. The treatment can decreased the rate of early cononary disease events. The efficiency is related with the dosage positively.