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目的 3-羟 3-甲基 -戊二酯辅酶A(HCM -COA)还原酶抑制剂能减少冠心病患者心血管事件的发生 ,但所有大型临床试验对冠心病的干预研究均在事件发生数月后进行 ,本研究旨在研究在急性冠脉综合征发作的早期 ,强化降脂治疗是否对病人有益。方法 采用随机、单盲、安慰剂对照方法 ,共入选 6 0例不稳定心绞痛或急性心肌梗死病人 ,均在入院后 4 8h内随机分配至安慰剂组 (n =2 0 ) ,阿托伐他汀组 10mg/d(n =2 0 ) ,阿托伐他汀组 2 0mg/d(n =2 0 )。 3组主要基本资料具有可比性。分别在用药后 8周检测脂质水平及通过臂部超声检测内皮依赖性流量介导的血管扩张 ,并随访 3个月内所有不良反应和心血管事件。结果 分组前 3组血脂水平相似 ,8周后阿托伐他汀组 10mg/d治疗的病人 :血清胆固醇 (TC)下降 30 % ,低密度脂蛋白 (LDL -C)下降 4 0 % ,甘油三酯 (TG)下降 30 % ;阿托伐他汀组 2 0mg/d治疗的病人 :TC水平下降 32 % ,水平下降 4 0 8% ,水平下降 (TG)38% ;与安慰剂组对照有显著差异 (P〈0 0 5 )。阿托伐他汀组治疗 8周后改善了臂部动脉内皮依赖性流量介导的血管扩张 ,10mg/d组由 ( 4 93± 0 5 ) %增加至 ( 6 5± 0 6 ) % ,2 0mg/d组由 ( 4 85± 0 81) %增加至 ( 7 2±0 79) % ,安慰剂组未观察到变化。结
Objective HCM-COA reductase inhibitors can reduce the incidence of cardiovascular events in patients with coronary heart disease, but all large clinical trials of coronary heart disease intervention studies are the number of events Months later, this study was designed to investigate whether enhancing lipid-lowering therapy is beneficial to patients early in the onset of acute coronary syndrome. Methods A total of 60 patients with unstable angina or acute myocardial infarction were enrolled in this study. Randomized, single-blind, and placebo-controlled trials were randomized to placebo within 48 hours of admission (n = 20), atorvastatin Group 10mg / d (n = 20), atorvastatin group 20mg / d (n = 20). 3 sets of basic information is comparable. Lipid levels were measured 8 weeks after drug administration and endothelium-dependent flow-mediated vasodilation was detected by arm ultrasound and all adverse events and cardiovascular events were followed up for 3 months. Results The levels of blood lipid in the first three groups were similar. After 8 weeks of treatment, patients in the atorvastatin group treated with 10 mg / d had a 30% reduction in serum cholesterol (TC) and a 40% decrease in low density lipoprotein (LDL-C) (TG) decreased 30%; Atorvastatin group 20mg / d treatment of patients: TC level decreased 32%, level decreased 40%, level decreased (TG) 38%; compared with the placebo group was significantly different P <0 0 5). The atorvastatin group improved endothelium-dependent flow-mediated vasodilation in the arm arteries after 8 weeks of treatment, from (4 93 ± 0 5)% to (6 5 ± 0 6)% and 20 mg / d group increased from (4 85 ± 0 81)% to (72 ± 0 79)%, while no changes were observed in the placebo group. Knot