早期阿托伐他汀强化疗法治疗不稳定型心绞痛疗效评价

目的 评价早期阿托伐他汀强化疗法治疗不稳定型心绞痛(UA)的疗效。方法 116例UA患者完全随机分为2组，阿托伐他汀40 mg/d组63例，给予阿托伐他汀钙40 mg/d口服；阿托伐他汀10 mg/d 组53例，给予阿托伐他汀10 mg/d口服，用药时间均为2周。2组其他治疗措施相同。观察2组患者治疗后临床疗效和心电图、血清高敏C反应蛋白(hs-CRP)及血脂改变情况。结果 用药2周后，阿托伐他汀40 m/d组显效28例(44.4％)、有效30例(47.6％)、无效3例(4.8％)、加重2例(3.2％)；阿托伐他汀10 mg/d组显效7例(13.2％)、有效8例(15.1％)、无效28例(52.8％)、加重10例(18.9％)。2组总有效率差异有统计学意义(P＜0.05)。心电图疗效方面，阿托伐他汀40 mg/d组显效26例(41.3％)、有效32例(50.8％)、无效4例(6.3％)、加重1例(1.6％)；阿托伐他汀10 mg/d组显效6例(11.3％)、有效10例(18.9％)、无效26例(49.1％)、加重11例(20.8％)。2组总有效率差异有统计学意义(P＜0.05)。阿托伐他汀40 mg/d组治疗前后hs-CRP水平分别为(8.97±3.72)、(4.26±1.08) mg/L；阿托伐他汀10 mg/d组则分别为(9.13±3.58)、(6.10±1.67) mg/L。2组hs-CRP水平与治疗前相比，均有明显下降(P＜0.05)，但阿托伐他汀40 mg/d组治疗前后比较下降更明显，治疗后组间hs-CRP比较差异具有统计学意义(P＜0.05)。阿托伐他汀40 mg/d组发生心脏事件2例，均为急性心肌梗死。阿托伐他汀10 mg/d组发生心脏事件11例（20.7％），其中急性心肌梗死10例，心源性猝死1例。阿托伐他汀40 mg/d组总缺血事件明显低于阿托伐他汀10 mg/d组，差异有统计学意义(P＜0.01)。2组间药物不良反应发生率差异无统计学意义。结论 在常规治疗基础上采用早期阿托伐他汀强化疗法治疗UA，可减少心血管事件的发生，改善预后，且治疗具有良好的安全性。

Evaluations of curative effects of early intensive therapy with atorvastatin for treating unstable angina patients

Objective To discuss the application value of early therapy with atorvastatin for stabilize mottle, anti-inflammatory and anti-myocardial ischemia in unstable angina(UA) patients on the basis of routine treatment. Methods Totally 116 cases of unstable angina patients were randomly divided into two groups. Group A (63 cases) were administered atorvastatin 40 mg/d; Group B(53 cases) were administered atorvastatin 10 mg/d.The clinical effect, the electrocardiogram, hs-CRP and lipid conditions before and after the treatment were observed.Results The level of hs-CRP in group A with atorvastatin 40 mg/d declined from (8.97 ± 3.72) to (4.26 ±1.08 ) mg/L, and the level in group B with atorvastatin 10 mg/d declined from (9. 13 ± 3.58) to (6. 10 ± 1. 67) mg/L.The level of hs-CRP declined in both groups( P ＜ 0.05 ). For clinical effect, there were 28 conspicuous effective cases(44.4％ ), 30 effective cases(47.6％ ), 3 invalid cases(4.8％ ) and 2 aggravation cases(3.2％ ) in group A;7 conspicuous effective cases( 13.2％ ), 8 effective cases( 15.1％ ), 28 invalid cases (52.8％) and 10 aggravation cases( 18.9％ ) in group B. The total effective rate between the two groups were statistically significant( P ＜ 0. 05 ).For ECG effect, there were 26 conspicuous effective cases(41.3％ ), 32 effective cases(50.8％ ), 4 invalid cases (6.3％), and 1 aggravation case( 1.6％ ) in group A; 6 conspicuous effective cases( 11.3％ ), 10 effective cases ( 18.9％ ), 26 invalid cases(49.1％ ) and 11 aggravation cases ( 20.8％ ) in group B. The total effective rate between the two groups were statistically significance( P ＜0.05 ). In group A, 2 cardiac incidents happened (3.2％)with acute myocardial infarction. 11 cases (20.7％) had the cardiac incidents in group B, including acute myocardial infarction in 10 cases and sudden cardiac death in I case. Total ischemic events rate in group A was lower than that in group B. Conclusion Early intensive therapy with atorvastatin will intervene inflammation, reduce the cardiovascular events and improve the prognosis of UA patients.