CAJ | 학술논문

目的：探讨急性冠脉综合征（ACS ）患者住院期间短期大剂量瑞舒伐他汀强化治疗的安全性和有效性。方法将急性冠脉综合征患者131例随机分为他汀强化组与常规组，强化组入院即给予瑞舒伐他汀20mg顿服，住院期间予瑞舒伐他汀20mg/晚口服；常规治疗组入院起予瑞舒伐他汀10mg/晚口服。强化组及常规组患者均于入院时及入院1周检测相关生化指标。结果治疗前两组患者年龄、性别、合并疾病、吸烟、肥胖情况及肌酐（Cr ）、肌酸激酶（CK ）、肾小球滤过率（GFR）比较差异无统计学意义（ P＞0.05），常规组谷丙转氨酶（ALT）水平高于强化组，差异有统计学意义（ P＜0.05）。治疗1周时，两组的ALT、AST均较前升高，差异有统计学意义（ P＜0.05）。但均值仍在正常范围内，两组间ALT ，AST升高大于3倍的比例无显著差异；所有患者治疗前后Cr、CK、GFR水平比较差异无统计学意义（ P＞0.05）。治疗1周后，两组的甘油三脂（TG ）、总胆固醇（TC ）、低密度脂蛋白（LDL_C ）均较前明显下降，强化治疗组LDL_C水平下降更显著，差异均有统计学意义（ P＜0.01）。常规组治疗1周，HDL_C无明显改变，而强化组患者HDL_C水平明显升高，差异有统计学意义（ P＜0.01）。结论瑞舒伐他汀20mg短期强化治疗安全性与10mg相同，且能迅速有效降低患者胆固醇水平，提高高密度脂蛋白水平。
목적：탐토급성관맥종합정（ACS ）환자주원기간단기대제량서서벌타정강화치료적안전성화유효성。방법장급성관맥종합정환자131례수궤분위타정강화조여상규조，강화조입원즉급여서서벌타정20mg돈복，주원기간여서서벌타정20mg/만구복；상규치료조입원기여서서벌타정10mg/만구복。강화조급상규조환자균우입원시급입원1주검측상관생화지표。결과치료전량조환자년령、성별、합병질병、흡연、비반정황급기항（Cr ）、기산격매（CK ）、신소구려과솔（GFR）비교차이무통계학의의（ P＞0.05），상규조곡병전안매（ALT）수평고우강화조，차이유통계학의의（ P＜0.05）。치료1주시，량조적ALT、AST균교전승고，차이유통계학의의（ P＜0.05）。단균치잉재정상범위내，량조간ALT ，AST승고대우3배적비례무현저차이；소유환자치료전후Cr、CK、GFR수평비교차이무통계학의의（ P＞0.05）。치료1주후，량조적감유삼지（TG ）、총담고순（TC ）、저밀도지단백（LDL_C ）균교전명현하강，강화치료조LDL_C수평하강경현저，차이균유통계학의의（ P＜0.01）。상규조치료1주，HDL_C무명현개변，이강화조환자HDL_C수평명현승고，차이유통계학의의（ P＜0.01）。결론서서벌타정20mg단기강화치료안전성여10mg상동，차능신속유효강저환자담고순수평，제고고밀도지단백수평。
Objective To evaluate the efficacy and safety of large doses intensive rosuvastatin treatment in short_term among the pa-tients with acute coronary syndrome (ACS ) during hospitalization.Methods A total of 131 ACS patients were 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 hospitalization.The patients in the general group were given 10mg every night during hospitalization.All the patients were given the biochemical indexes detection both on admission and after one week’s treatment.Results Age ,gender ,complications ,smoking ,overweight ,creatinine(Cr) ,creatine kinase(CK) ,and glomeru-larfiltrationrate(GFR)weresimilarbetweentwogroups (P>0.05).Levelsofbasicalanineaminotransferase (ALT)inconventional group were higher than that in intensive group.After one week’s treatment ,alanine aminotransferase (ALT) and aspartate amino-transferase (AST ) were higher in both groups ,which had a significantly difference than before ( P<0.05 ) ,but still in normal range.Compared with 10mg group ,there was no significant increase in the proportion of 3_times increased in ALT ,and AST in 20mg group.No differences were found in CK ,Cr and GFR after one week’s therapy in both groups.After one week’s therapy ,blood total choles-terol ,triglycerides and LDL cholesterol were lower than before in both groups ,but LDL_C of intensive treatment were significantly lower than conventional treatment.HDL_C had no significantly differences in conventional group but significantly higher in the inten-sive group after one week’s treatment.Conclusions The 20mg short_term intensive rosuvastatin treatment is as safe as the 10mg gen-eral treatment ,and effectively reduce the lipid and cholesterol levels ,and increase the high density lipoprotein.