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近年来,多项临床研究均证实在ACS高危人群中,使用阿司匹林、β受体阻滞剂、ACEI等标准治疗的基础上,强化降脂可以进一步降低心血管事件的患病率和病死率[1]。而他汀类药物的不良反应是剂量的依赖性的,如何采取合理的治疗剂量,避免盲目地大剂量用药是减少他汀类药物不良反应的有效措施之一[2]。我们知道:有50%的心肌梗死者并无高血脂[3],所以并不总是能根据血脂水平来决定他汀类药物的用量。一些研究结果表明,CRP水平是一个重要的心血管标志物,也是独立的危险因素[4]。我们试图根据CRP水平来决定他汀类药物剂量,以期达到满意的疗效及安全性,现将资料总结如下:
In recent years, a number of clinical studies have confirmed that in ACS high-risk groups, the use of aspirin, β-blockers, ACEI and other standard treatment based on the enhanced lipid-lowering can further reduce the prevalence of cardiovascular events and mortality [ 1]. The statin adverse reactions are dose-dependent, how to take a reasonable dose, to avoid blind high-dose medication is one of the effective measures to reduce the adverse reactions of statins [2]. We know that 50% of people with myocardial infarction do not have hyperlipidemia [3], so statin use does not always depend on the level of blood lipids. Some studies have shown that CRP level is an important cardiovascular marker, but also an independent risk factor [4]. We try to determine the dose of statins according to CRP level, in order to achieve satisfactory efficacy and safety, the data are summarized as follows: