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

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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20rng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。 Objective To investigate the efficacy and safety of short-term high-dose atorvastatin in patients with acute coronary syndrome (ACS) during hospitalization. Methods A total of 355 patients with ACS were enrolled in this study. Among them, 180 patients in the intensive group (atorvastatin 80 mg on admission, atorvastatin 80 mg / night during hospitalization, regardless of coronary intervention) Starting atorvastatin 20mg / night). Both groups were biochemically tested at admission and one week after admission [including validity indicators (TG, TC, HDL-C, LDL-C) and safety indicators (ALT, AST, Cr, CK and CK-MB) ] And record the result. Results The levels of TC, TG and LDL-C in both groups decreased significantly and the level of HDL-C significantly increased after one week of treatment (all P <0.01). Compared with the conventional group, TG levels increased more significantly, the difference was statistically significant (P <0.05). The levels of Cr, CK and CK-MB in the two groups were significantly improved after treatment for 1 week (all P <0.01). Compared with the conventional group, the levels of ALT and AST in the intensive group were significantly increased, The difference was statistically significant (both P <0.01). Conclusions The safety of 80mg short-term atorvastatin is the same as that of 20rng. It can effectively reduce the level of TG, TC and LDL-C and increase the level of HDL-C in patients with clinical benefit.
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