急性冠脈綜合征患者短期大劑量瑞舒伐他汀治療安全性和有效性的研究

來蕾+朱剛杰+王寧夫+李虹+童國新+楊建敏+葉顯華+周亮+潘浩

[摘 要] 目的 探討急性冠脈綜合征（ACS）患者住院期間短期大劑

量瑞舒伐他汀強化治療的安全性和有效性?

方法 將急性冠脈綜合征患者131例隨機分為他汀強化組與常規組，強化組

入院即給予瑞舒伐他汀20mg頓服，住院期間予瑞舒伐他汀20mg/晚口服；常規治療組入院起

予瑞舒伐他汀10mg/晚口服?強化組及常規組患者均于入院時及入院1周檢測相關生化指標?

結果 治療前兩組患者年齡?性別?合并疾病?吸煙?肥胖情況及肌酐（C

r）?肌酸激酶（CK）?腎小球濾過率（GFR）比較差異無統計學意義（P>0.05），常

規組谷丙轉氨酶（ALT）水平高于強化組，差異有統計學意義（P<0.05）?治療1周

時，兩組的ALT?AST均較前升高，差異有統計學意義（P<0.05）?但均值仍在正常范

圍內，兩組間ALT，AST升高大于3倍的比例無顯著差異；所有患者治療前后Cr?CK?GFR水平

比較差異無統計學意義（P>0.05）?治療1周后，兩組的甘油三脂（TG）?總膽固醇

（TC）?低密度脂蛋白（LDL_C）均較前明顯下降，強化治療組LDL_C水平下降更顯著，差異

均有統計學意義（P<0.01）?常規組治療1周，HDL_C無明顯改變，而強化組患者HDL_

C水平明顯升高，差異有統計學意義（P<0.01）?

結論 瑞舒伐他汀20mg短期強化治療安全性與10mg相同，且能迅速有效降

低患者膽固醇水平，提高高密度脂蛋白水平?

[關鍵詞] 瑞舒伐他汀；急性冠脈綜合征；血脂

中圖分類號：R541.4：R972

文獻標識碼：A 文章編號：1009_816X

（2014）01_0019_03

doi：10.3969/j.issn.1009_816x.2014.01.08

The Efficacy and Safety of Short Term Intensive Rosuvastatin Therapy in Acute Co

ronary Syndrome.

LAI Lei， ZHU Gang_jie， WANG Ning_fu， et al. The First People

's Hospital of Hangzhou， Zhejiang 310006，China

[Abstract] Objective To evaluate the efficacy and safety of la

rge doses intensive rosuvastatin treatment in short_term among the patients wit

h acute coronary syndrome （ACS） during hospitalization.

Methods A total of 131 ACS patients wer

e enrolled into this study. They were randomly divided into the intensive group

and conventional group. The patients in the intensive group were given 20mg ro

suvastatin as soon as admission， 20mg rosuvastatin every night during hospitaliz

ation. The patients in the general group were given 10mg every night during hos

pitalization. All the patients were given the biochemical indexes detection bot

h on admission and after one week's treatment.

Results Age， gender， complications， smoking， overweight， creatin

ine（Cr）， creatine kinase（CK）， and glomerular filtrat

ion rate（GFR） were similar between two groups （P>0.05）. Levels of basic a

lanine

aminotransferase （ALT） in conventional group were higher than that in intensive

group. After one week's treatment， alanine aminotransferase （ALT） and aspartat

e

aminotransferase（AST） were higher in both groups， which had a significantly dif

ference than before（P<0.05）， but still in normal range. Compared with 10m

g grouendprint

p， there was no significant increase in the proportion of 3_times increased in A

LT， and AST in 20mg group. No differences were found in CK， Cr and GFR after on

e

week's therapy in both groups. After one week's therapy， blood total cholester

o

l， triglycerides and LDL cholesterol were lower than before in both groups， but

LDL_C of intensive treatment were significantly lower than conventional treatmen

t. HDL_C had no significantly differences in conventional group but significan

tly higher in the intensive group after one week's treatment.

Conclusions The 20mg

short_term intensive rosuvastatin treatment is as safe as the 10mg general trea

tment， and effectively reduce the lipid and cholesterol levels， and increase the

high density lipoprotein.

[Key words] Rosuvastatin； Acute coronary syndrome； Blood lipid

他汀類藥物通過調脂及調脂外的抗炎?抗氧化作用，不但能降低冠心病的發病率并且能改變

冠

心病的病程，使病變進展延緩，甚至逆轉[1]，目前已成為冠心病，尤其是急性冠

脈綜合征

（ACS）藥物治療的基石……