急诊强化他汀治疗在急性冠脉综合征患者中的应用安全性效果观察
Observed the safety and effect of using emergency intensive statin therapy in acute coronary syndrome patients

马健,张勇.急诊强化他汀治疗在急性冠脉综合征患者中的应用安全性效果观察[J].内科急危重症杂志,2015,21(3):

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英文关键词:Atorvastatin Acute coronary syndrome Security Clinical effect

基金项目:湖北省教育厅课题：妊娠相关血浆蛋白A与急性冠脉综合征的相关性及与炎性因子CD40的相互作用，编号：B2013123

作者	单位	E-mail
马健	湖北医药学院附属东风医院	maj4203@163.com
张勇	湖北医药学院附属东风医院	zhangy4203@163.com

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中文摘要:

【】:目的:探讨阿托伐他汀强化降脂应用于急性冠脉综合征患者的治疗效果及其安全性。方法：选取我院2009年1月-2013年1月间收治的急性冠脉综合征患者70例,将其随机分为强化组以及对照组。两组患者均予以阿司匹林、肝素、硝酸酯类、β-受体阻滞剂以及血管紧张素转换酶抑制剂等常规治疗。强化组患者在此基础上加用阿托伐他汀20mg*qn,连续治疗8周。对照组患者在此基础上加用阿托伐他汀10mg*qn,连续治疗8周。比较两组患者治疗前及治疗8周后的血清hs-CRP、IL-10以及MMP-9的变化情况,并观察治疗不良反应。结果：两组治疗前血清hs-CRP、IL-10和MMP-9水平比较无明显差异(P>0.05)。治疗8周后,两组血清hs-CRP和MMP-9水平均较前明显下降,血清IL-10水平较前明显上升(t＝2.44、2.27、2.46、3.05、2.91、2.92,P<0.05或P<0.01),且强化组下降或上升值较对照组更明显(t＝3.27、3.31、6.11,均P<0.05)。强化组治疗有效率为88.6%(31/35),对照组为68.6%(24/35),组间比较差异有统计学意义,(X2=4.16,P<0.05)。两组患者均未发生严重的不良反应事件。结论:急诊强化阿托伐他汀降脂治疗应用于急性冠脉综合征的治疗具有较好的效果,能降低血清hs-CRP和MMP-9水平,提高血清IL-10水平,从而抑制斑块局部炎性反应,提高动脉粥样硬化斑块的稳定性,且药物的安全性好。

英文摘要:

【】: Objective:Observed the safety and effect of using emergency intensive statin therapy in acute coronary syndrome patients. Methods:Select 70 cases of patients with acute coronary syndrome (acs) from January 2009 to January 2009 , randomly divided them into strengthening group and the control group. Two groups of patients both received aspirin and heparin, nitrate, beta blockers and angiotensin converting enzyme inhibitors for conventional treatment. The strengthen group used atorvastatin 20 mg * qn, continuous treatment of 8 weeks on the basis of it.the control group patients combined with atorvastatin 10 mg * qn, continuous treatment of 8 weeks on the basis of it. Compare serum hs - CRP, IL - 10 and the change of MMP - 9 in two groups of patients before and after 8 weeks treatment ,and observed the treatment adverse reactions in two groups. Results:Before treatment hs-CRP, IL - 10 and the level of MMP - 9 levels in two groups had no significant difference (P > 0.05). 8 weeks after treatment,hs - serum CRP and the level of MMP - 9 levels in two groups was markedly reduced,and significant increase in serum levels of IL - 10(t = 2.44, 2.27, 2.46, 3.05, 2.91, 3.05, P < 0.05 or P < 0.01), and strengthen the group down or up degree were more significantly than control group (t = 3.27, 3.31, 6.11, P < 0.05). See table 1.The effective rate of strengthening treatment group was 88.6% (31/35), the control group was 68.6% (24/35), the difference between groups was statistically significant, (X2 = 4.16, P < 0.05).There was no serious adverse events occured in both two groups of patients,. Conclusion: Emergency reinforcement atorvastatin lipid-lowering therapy applied in the treatment of acute coronary syndrome has a good effect, can reduce serum hs - CRP and MMP - 9 levels, improve the level of serum IL - 10, thus inhibiting plaque local inflammatory reaction, improve the stability of atherosclerotic plaque, and was safe.