摘要
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。
Objective To study the effect of lowering blood lipid intensively in tredting acute coronary syndrome. Methods Sixty patients who were hospitalized with unstable angina pectoris or acute myocardial infarction were divided into three groups randomly, i.e, control, Atrovastatin 10mg/d and Atrovastatin 20mg/d groups. Blood lipid and endothelium dependent vasodilation were measured after 8 weeks. Total harmful responses and cardiovascular accidents were followedby for three months. Results The level of cholesterol ?triglyceride ?LDL-C in Atrovastatin 10mg/d group decreasedby 30%?30%?40% respectively, and that in Atrovastatin 20mg/d group decreasedby 32%?38%?40 8% respectively, the difference between control and treatment group was significant (P<0 05). Vasodilatation induced by endothelium dependent increased from (4 93±0 5)% to (6 5±0 6)% in Atrovastatin 10mg/d group,and it increased from (4 85±0 81)% to (7 2± 0 79)% in Atrovastatin 20mg/d group. Conclusion Atrovastatin can lower lipid and improve vasodilatation induced by endothelium dependent. But the effect of Atrovastatin on cardiovascular accidents needs to be observed in more samples for a long time.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2003年第4期219-220,共2页
Chinese Journal of Practical Internal Medicine
