早期强化阿托伐他汀治疗对急性冠脉综合征患者血清脂联素与血脂水平的影响

目的观察急性冠脉综合征早期强化阿托伐他汀治疗的临床疗效。方法选择我院收治的急性冠脉综合征患者96例，随机分为研究组和对照组，每组48例。两组患者均给予溶栓、抗凝及抗血小板药物等常规治疗，研究组患者口服阿托伐他汀40mg／d，对照组患者口服阿托伐他汀10mg／d，疗程1个月。观察两组患者治疗前、治疗后24h、72h、1周及1个月血脂、血清脂联素（APN）和超敏C反应蛋白（hs-CRP）水平，随访6个月，观察两组患者的心血管事件发生率及药物不良反应。结果治疗前两组总胆固醇（Tc）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、APN及hs．CRP水平比较差异无统计学意义（P〉0．05）。治疗后72h开始两组AlaN水平较治疗前明显升高，hs-CRP水平较治疗前明显降低CP〈0．05），治疗后72h研究组LDL-C水平较治疗前阴显降低（P〈0.05），治疗72h、1周、1个月研究组血清APN明显高于对照组，hs．CRP水平明显低于对照组（P〈0．05），治疗1个月研究组LDL-C、TC明显低于对照组（P〈0．05）。6个月内研究组心血管事件发生率明显低于对照组（P〈0．01）。两组治疗期间均无严重不良反应发生。结论早期强化阿托伐他汀治疗可以有效降低患者血脂水平，减少近期心血管事件发生，其作用可能与阿托伐他汀提高血清脂联素水平，降低炎症反应有关。

Effect of early intensive atorvastatin treatment on serum adiponectin and blood lipid level in patients with acute coronary syndrome.

Objective To study the effect of early intensive atorvastatin treatment for acute coronary syndrome. Methods Ninety-six patients of acute coronary artery in our hospital were randomly divided into the study group and the control group, with 48 cases in each group. Patients in the study group received atorvastatin 40 mg/d, and patients in the control group received atorvastatin 10 mg/d, both for 1 month. The blood lipid, serum adiponectin （APN）, and high sensitivity C reactive protein （hs-CRP） levels were observed before treatment, and 24 h, 72 h, 1 week and 1 month after treatment. The incidence of cardiovascular events and adverse drug reactions were observed during the follow-up of 6 months. Results Before treatment, the two groups showed no statistically significant difference in total cholesterol （TC）, triglyceride （TG）, low density lipoprotein cholesterol （LDL-C）, high density lipoprotein cholesterol （HDL-C）, APN and hs-CRP levels （P〉0.05）. 72 h after treatment, the APN levels of two group was significantly higher than before treatment, the level of hs-CRP was significantly lower （P〈0.05）, and the level of LDL-C were significantly lower （P〈0.05）. 72 h, 1 week, 1 month after treatment, serum APN of the study group was significantly higher than that of the control group, the level of hs-CRP was significantly lower than the control group （P〈0.05）. One month after treatment, the LDL-C, TC levels were significantly lower in the study group than the control group （P〈 0.05）. The incidence of cardiovascular events in the study group was significantly lower than the control group （P〈 0.01）. There were no serious adverse reactions in the two groups during the follow-up. Conclusion Early intensive atorvastatin therapy can effectively decrease the blood lipid levels, and reduce the incidence of cardiovascular events. The effects may be related to the fact that atorvastatin increases serum adiponectin levels and reduces inflammation.