摘要
目的探讨不同剂量瑞舒伐他汀对ACS患者血清的s LOX-1水平的早期作用,探讨负荷剂量他汀应用安全性。方法选择急性冠状动脉综合征患者80例,随机分为瑞舒伐他汀10 mg组40例及瑞舒伐他汀5 mg组40例。瑞舒伐他汀10 mg组入院后立即给予瑞舒伐他汀40 mg负荷剂量及瑞舒伐他汀10 mg,每晚1次,瑞舒伐他汀5 mg组予瑞舒伐他汀5 mg,每晚1次。观察住院期间MACE事件发生率,监测药物不良反应;采用酶联免疫法测定患者入院即刻、入院后第3天血清s LOX-1水平并进行前后比较及组间比较。结果瑞舒伐他汀10 mg组入院第三天血清s LOX-1浓度为290.03±141.43 ng/L,较入院即刻血清s LOX-1浓度397.86±170.61 ng/L明显下降,降低幅度为27.1%(t=4.625,P<0.001);瑞舒伐他汀5 mg组入院第三天血清s LOX-1浓度为300.03±135.31 ng/L,较入院即刻血清s LOX-1浓度385.66±154.39 ng/L明显下降,降低幅度为22.2%(t=3.329,P<0.05);两组间比较入院即刻血清s LOX-1浓度差异无显著性(t=-0.335,P=0.739);两组间s LOX-1降低幅度比较差异无显著性(t=-0.639,P=0.525)。两组入院即刻血白细胞计数及中性粒细胞百分比无差异,治疗后均下降,其中瑞舒伐他汀10组下降更显著(t=2.254,P<0.05);瑞舒伐他汀10 mg组住院期间MACE事件发生率低于瑞舒伐他汀5 mg组(χ2=4.588,P<0.05)。两组住院期间无药物不良反应发生。结论早期他汀治疗能够显著降低ACS患者血清s LOX-1浓度;负荷剂量及中等剂量他汀治疗能降低住院期间MACE发生率,且较为安全。
Aim To evaluate the effect of rosuvastatin medication with different doses on serum level of soluble lectin-like oxidized low-density lipoprotein receptor-1( s LOX-1) in patients with acute coronary syndrome( ACS).Methods Patients( n = 80) with ACS were randomly assigned into rosuvastatin 10 mg group(40 mg loading dose and 10 mg / d,RSV10 group,n = 40) and rosuvastatin 5 mg group( 5 mg / d,RSV5 group,n = 40). All patients were accepted based on the clinical situation,including coronary revascularization,and aspirin,clopidogrel hydrogen,tirofiban,low molecular weight heparin,ACEI / ARB,β-blockers,calcium channel blockers,nitric acid esters drugs,diuretics and other basic drugs. Major adverse cardiac events( MACE) were observed during hospitalization,monitoring adverse drug reactions. Serum s LOX-1 levels of immediate admission on the third day were determinated using enzyme-linked immunosorbent assay and were compared between groups. Results Baseline characteristics were nearly identical in both groups.The density of s LOX-1 on the third day during hospitalization is 290. 03 ± 141. 43 ng / L in RSV10 group,which remarkablely decreases in comparison with the value of 397. 86 ± 170. 61 ng / L on admission. Reduce of the rate is 27. 1%( t =4. 625,P < 0. 001); The density of s LOX- 1 in the third day during hospitalization is 300. 03 ± 135. 31 ng / L in RSV5 group. The value of s LOX- 1 declined significantly as well compared with 385. 66 ± 154. 39 ng / L on admission,and the reduction is 22. 2%( t = 3. 329,P < 0. 05); The comparison of the s LOX-1 density between the two groups on admission has no significance( t =- 0. 335,P = 0. 739); The reduction has no significance as well between the two groups( t =- 0. 639,P = 0. 525). There is no difference in leukocyke count and neutrophil percentage,which actually decreased after treatment in both groups and RSV10 group decreased more significantly( t = 2. 254,P < 0. 05); The rate of MACE during hospitalization in RSV10 group is lower than RSV5 group( χ2= 4. 588,P < 0. 05); There is no adverse drug recation during hospitalization in both two groups. Conclusion In clinical practice,early rosuvastatin treatment could significantly decrease the serum density of s LOX-1 in patients with ACS,obviously. Besides,the effect showed no dose dependent. Loadingdose and mild moderate-dose statin,which is relatively safe,could reduce the incidence of MACE during hospitalization.
出处
《中国动脉硬化杂志》
CAS
北大核心
2015年第4期392-396,共5页
Chinese Journal of Arteriosclerosis
