摘要
目的:观察急性冠脉综合征(ACS)患者接受强化剂量瑞舒伐他汀治疗的远期疗效,并探讨其可能机制,为临床诊疗提供参考。方法:将我院2013年1月-2015年1月临床治愈后接受瑞舒伐他汀治疗的ACS患者102例,按照瑞舒伐他汀剂量的不同分为观察组和对照组,其中观察组55例,对照组47例。两组患者均在同一组医师的指导下,在常规治疗的基础上接受瑞舒伐他汀钙片治疗,观察组剂量为20 mg,qd,po,对照组为10 mg,qd,po。两组患者均治疗1年。比较两组患者1年主要心脏事件(MACE)累积发生率、治疗前及治疗3个月后血脂水平、血清细胞因子水平及不良反应发生情况。结果:观察组患者1年内MACE累积发生率显著低于对照组患者,差异有统计学意义(P<0.05)。治疗后,两组患者总胆固醇(TC)及低密度脂蛋白胆固醇(LDL-C)水平均较治疗前显著降低,高密度脂蛋白胆固醇(HDL-C)水平较治疗前显著升高,且观察组LDL-C水平显著低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者血清白细胞介素1β(IL-1β)及肿瘤坏死因子α(TNF-α)水平均较治疗前显著降低(P<0.05),且观察组显著低于对照组,差异有统计学意义(P<0.05)。观察组患者治疗后外周血LDL-C与IL-1β、TNF-α均呈现显著正相关关系,有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:强化剂量瑞舒伐他汀治疗可显著改善ACS患者的远期预后,这可能与其调控脂质代谢及抗炎作用有关。
OBJECTIVE:To observe long-term efficacy of intensive rosuvastatin therapy in the treatment of acute coronary syndrome(ACS)and explore its possible mechanism,so as to provide reference for clinical diagnosis and treatment.METHODS:ACS patients receiving rosuvastatin after cured in our hospital during Jan.2013-Jan.2015were divided into observation group(55cases)and control group(47cases)according to the dose of rosuvastatin.Under same guidance of physicans,2groups were additionally given Rosuvastatin calcium tablets(20mg for observation group,10mg for control group,qd,po)orally on the basis of routine treatment.Both groups were treated for1year.The incidence of1-year accumulative main adverse cardiac event(MACE)were compared between2groups as well as the levels of blood lipid and serum cytokines,the occurrence of ADR before treatment,after3months of treatment.RESULTS:The incidence of accumulative MACE in observation group was significantly lower than control group,with statistical significance(P<0.05).After treatment,the levels of TC and LDL-C in2groups were decreased significantly;the level of LDL-C was inCreased significantly compared to before treatment,and the observation group wassignificantly lower than the control group,with statistical significance(P<0.05).The levels of IL-1βand TNF-αin2groups weredecreased significantly(P<0.05);the observation group was significantly lower than the control group,with statistical significance(P<0.05).The peripheral blood LDL-C was positively correlated with IL-1βand TNF-αin observation group after treatment,with statistical significance(P<0.05).There was no statistical significance in the incidence of ADR between2groups(P>0.05).CONCLUSIONS:Intensive rosuvastatin therapy can significantly improve the long-term prognosis for ACS patients,which may associate with lipid metabolic regulation and anti-inflammatory effect.
作者
刘梅
李桂伟
LIU Mei;LI Guiwei(Dept. of Emergency,the First Affiliated Hospital of Tianjin University of TCM,Tianjin 300193,China)
出处
《中国药房》
CAS
北大核心
2017年第11期1510-1513,共4页
China Pharmacy
关键词
急性冠脉综合征
瑞舒伐他汀
主要心血管事件
血脂
预后
Acute coronary syndrome
Rosuvastatin
Major adverse cardiac event
Blood lipid
Prognosis
作者简介
副主任医师，硕士。研究方向：感染、心脑血管、中西医结合内科、急救医学。电话：022-60269090。E-mail：15922043059@163.com
