急性冠状动脉综合征患者短期大剂量他汀治疗的有效性及安全性研究

目的：探讨急性冠状动脉综合征（ACS）患者住院期间短期大剂量阿托伐他汀强化治疗的有效性及安全性。方法选取ACS患者355例，其中强化组180例（入院即给予阿托伐他汀80mg，无论是否行冠脉介入治疗，均在住院期间予阿托伐他汀80mg/晚），常规组175例（入院起予阿托伐他汀20mg/晚）。两组患者均于入院时及入院后1周后均予生化检查[包括有效性指标（TG、TC、HDL- C、LDL- C）及安全性指标（ALT、AST、Cr、CK、CK- MB）]并记录结果。结果两组患者治疗1周后，TC、TG、LDL- C水平均显著下降，HDL- C水平均显著升高，差异均有统计学意义（均P＜0.01）；与常规组比较，强化组TG水平升高更明显，差异有统计学意义（P＜0.05）。两组患者治疗1周后Cr、CK、CK- MB均较治疗前明显改善，差异均有统计学意义（均P＜0.01）；与常规组比较，强化组ALT及AST水平升高更明显，差异均有统计学意义（均P＜0.01）。结论80mg短期阿托伐他汀强化治疗的安全性与20mg相同，能迅速有效降低患者TG、TC和LDL- C水平，提高HDL- C水平，临床获益更大。

Efficacy and safety of short term intensive statin therapy for acute coronary syndrome

Objective To evaluate the efficacy and safety of shortterm high doses of atorvastatin intensive treatment for patients with acute coronary syndrome （ACS） during hospitalization. Methods A total of 355 ACS patients who were treated in our hospital were enrol ed into this study. Among them 180 cases received atorvastatin 80mg at admission and atorvastatin 80mg/night during the hospitalization （intensive group）, and other 175 cases received atorvastatin 20mg/night） from admission （convention group）. The serum levels ALT, AST, Cr, TG, TC, HDL- C, LDL- C, creatine kinase （CK） and creatine kinase isoenzyme （CK- MB） at admission and 1 week after admission were measured in both groups. Results The TC, TG and LDL- C levels were significantly lower and HDL- C levels were significantly higher at 1 week after treatment than those at baseline levels in both groups （al P〈0.01）;while The TG levels in intensive group were significantly higher than those in conventional group 1 week after treatment （P〈0.05）. The ALT, AST, Cr, CK and CK- MB levels were improved significantly in both groups 1 week after treatment （P〈0.01）;while compared with the conventional group, the ALT and AST levels in intensive group were markedly increased （P〈0.01）. Conclusion The shortterm intensive statin therapy is as safe as the conventional treatment, but is more effective for pa-tients with acute coronary syndrome.