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目的探讨不同剂量阿托伐他汀对急性冠脉综合征(ACS)患者降脂效果及主要心脑血管事件的影响。方法回顾性分析2013年1月-2014年12月心血管内科75例ACS患者,入院后首次给予阿托伐他汀20mg(20mg组,n=45)或40mg(40mg组,n=30)剂量治疗,维持治疗6个月。对比观察2组治疗1、6个月血脂和肝功能指标变化情况,评估2组维持治疗6月主要心脑血管事件发生情况。结果治疗前,2组TC、LDL-C水平差异无统计学意义(P>0.05)。治疗1、6个月时2组TC、LDL-C均显著降低(P均<0.05),其中40mg组TC和LDL-C下降幅度显著大于20mg组,差异均有统计学意义(P<0.05)。治疗前与治疗1、6月时2组均未见转氨酶>3×ULN病例。2组均未见严重肌肉不良事件和肾脏毒性发生。治疗6个月内,40mg组和20mg组主要心脑血管事件发生率分别为20%和42.2%,2组比较差异有统计学意义(P<0.05)。结论 ACS患者接受40mg剂量阿托伐他汀维持治疗是安全的,降脂效果更佳,并可降低主要心脑血管事件风险。
Objective To investigate the effects of different doses of atorvastatin on lipid-lowering effect and cardiovascular and cerebrovascular events in patients with acute coronary syndrome (ACS). Methods A retrospective analysis of 75 patients with ACS admitted to Department of Cardiology from January 2013 to December 2014 was given atorvastatin 20 mg (20 mg, n = 45) or 40 mg (n = 30) for the first time after admission , To maintain treatment for 6 months. The changes of blood lipid and liver function indexes in the two groups were observed and compared in the two groups. The incidence of major cardiovascular and cerebrovascular events in the two groups were evaluated. Results Before treatment, TC and LDL-C levels in the two groups had no significant difference (P> 0.05). The levels of TC and LDL-C in two groups were significantly decreased at 1 month and 6 months after treatment (all P <0.05), and the decrease of TC and LDL-C in 40 mg group was significantly greater than that of 20 mg group (P <0.05) . Before treatment and treatment of 1, 6 months, no transaminase> 3 × ULN cases were found in both groups. No severe muscular adverse events and nephrotoxicity occurred in both groups. Within 6 months of treatment, the incidences of major cardiovascular events in the 40 mg and 20 mg groups were 20% and 42.2%, respectively, with significant difference between the two groups (P <0.05). Conclusions ACS patients receiving 40 mg dose of atorvastatin are safe, lipid-lowering, and reduce the risk of major cardiovascular and cerebrovascular events.