中华全科医师杂志
中華全科醫師雜誌
중화전과의사잡지
CHINESE JOURNAL OF GENERAL PRACTITIONERS
2014年
5期
365-368,369
,共5页
孙丽娜%王宁夫%康兰%高微%李虹%来蕾%潘浩%叶显华%周亮%童国新%杨建敏%徐鹏%周占林
孫麗娜%王寧伕%康蘭%高微%李虹%來蕾%潘浩%葉顯華%週亮%童國新%楊建敏%徐鵬%週佔林
손려나%왕저부%강란%고미%리홍%래뢰%반호%협현화%주량%동국신%양건민%서붕%주점림
急性冠脉综合征%降血脂药%治疗结果
急性冠脈綜閤徵%降血脂藥%治療結果
급성관맥종합정%강혈지약%치료결과
Coronary Disease%Antilipemic agents%Treatment outcome
目的:探讨短期强化他汀在急性冠状动脉(冠脉)综合征患者治疗中的临床疗效及安全性。方法入组2013年3月至7月本院就诊的急性冠脉综合征患者共218例,按单双号随机入组法分为强化组(107例)与常规组(111例):强化组入院及住院期间均予阿托伐他汀80 mg/晚,出院后予阿托伐他汀40 mg/晚;常规组入院及住院期间均予阿托伐他汀20 mg/晚,出院后予阿托伐他汀20 mg/晚。于入院时及出院后1个月检测两组患者相关生化指标并进行比较。结果强化组治疗1个月后,其TC、TG、LDL-C等均较前显著下降[分别为(1.52±0.88)比(0.75±0.14) mmol/L,P<0.05;(4.55±1.12)比(2.21±0.78) mmol/L,P<0.05;(2.23±0.77)比(1.76±0.31) mmol/L,P<0.05];而HDL-C升高明显[(1.15±0.34)比(1.52±0.41) mmol/L,P<0.05]。与常规组相比,强化组1个月后其肝酶及肌酸激酶等无明显增加,肌酐水平较治疗前有所下降[(82.53±23.85)比(57.81±15.27)μmol/L,P<0.05];同时患者的血同型半胱氨酸及超敏CRP水平较前下降[分别为(30.70±18.82)比(10.52±4.66) mmol/L,P <0.05;(19.75±11.91)比(8.06±2.68) mg/L,P <0.05]。结论短期强化他汀治疗在保证用药安全的前提下,能快速有效地降低患者的TC、TG、LDL-C及同型半胱氨酸水平,提高HDL-C,并有一定的抗炎、肾功能保护作用,患者临床获益大。
目的:探討短期彊化他汀在急性冠狀動脈(冠脈)綜閤徵患者治療中的臨床療效及安全性。方法入組2013年3月至7月本院就診的急性冠脈綜閤徵患者共218例,按單雙號隨機入組法分為彊化組(107例)與常規組(111例):彊化組入院及住院期間均予阿託伐他汀80 mg/晚,齣院後予阿託伐他汀40 mg/晚;常規組入院及住院期間均予阿託伐他汀20 mg/晚,齣院後予阿託伐他汀20 mg/晚。于入院時及齣院後1箇月檢測兩組患者相關生化指標併進行比較。結果彊化組治療1箇月後,其TC、TG、LDL-C等均較前顯著下降[分彆為(1.52±0.88)比(0.75±0.14) mmol/L,P<0.05;(4.55±1.12)比(2.21±0.78) mmol/L,P<0.05;(2.23±0.77)比(1.76±0.31) mmol/L,P<0.05];而HDL-C升高明顯[(1.15±0.34)比(1.52±0.41) mmol/L,P<0.05]。與常規組相比,彊化組1箇月後其肝酶及肌痠激酶等無明顯增加,肌酐水平較治療前有所下降[(82.53±23.85)比(57.81±15.27)μmol/L,P<0.05];同時患者的血同型半胱氨痠及超敏CRP水平較前下降[分彆為(30.70±18.82)比(10.52±4.66) mmol/L,P <0.05;(19.75±11.91)比(8.06±2.68) mg/L,P <0.05]。結論短期彊化他汀治療在保證用藥安全的前提下,能快速有效地降低患者的TC、TG、LDL-C及同型半胱氨痠水平,提高HDL-C,併有一定的抗炎、腎功能保護作用,患者臨床穫益大。
목적:탐토단기강화타정재급성관상동맥(관맥)종합정환자치료중적림상료효급안전성。방법입조2013년3월지7월본원취진적급성관맥종합정환자공218례,안단쌍호수궤입조법분위강화조(107례)여상규조(111례):강화조입원급주원기간균여아탁벌타정80 mg/만,출원후여아탁벌타정40 mg/만;상규조입원급주원기간균여아탁벌타정20 mg/만,출원후여아탁벌타정20 mg/만。우입원시급출원후1개월검측량조환자상관생화지표병진행비교。결과강화조치료1개월후,기TC、TG、LDL-C등균교전현저하강[분별위(1.52±0.88)비(0.75±0.14) mmol/L,P<0.05;(4.55±1.12)비(2.21±0.78) mmol/L,P<0.05;(2.23±0.77)비(1.76±0.31) mmol/L,P<0.05];이HDL-C승고명현[(1.15±0.34)비(1.52±0.41) mmol/L,P<0.05]。여상규조상비,강화조1개월후기간매급기산격매등무명현증가,기항수평교치료전유소하강[(82.53±23.85)비(57.81±15.27)μmol/L,P<0.05];동시환자적혈동형반광안산급초민CRP수평교전하강[분별위(30.70±18.82)비(10.52±4.66) mmol/L,P <0.05;(19.75±11.91)비(8.06±2.68) mg/L,P <0.05]。결론단기강화타정치료재보증용약안전적전제하,능쾌속유효지강저환자적TC、TG、LDL-C급동형반광안산수평,제고HDL-C,병유일정적항염、신공능보호작용,환자림상획익대。
Objective To evaluate the clinical efficacy and safety of short-term intensive statin therapy in patients with acute coronary syndrome ( ACS) .Methods A total of 218 ACS patients admitted in Hangzhou First People′s Hospital from March 2013 to July 2013 were enrolled into this study .The patients were randomly assigned to receive atorvastatin 80 mg/d during hospitalization , and 40 mg/night after discharge for one month ( intensive group , n=107 );or receive atorvastin 20 mg during hospitalization and 20 mg/night after discharge for one month ( control group, n =111 ).The biochemical indexes were measured on the admission and after one-month treatment.Results After one-month treatment, the total cholesterol, triglycerides and LDL cholesterol of intensive group were significantly lower , and the high density lipoprotein cholesterol was higher than baseline values ( 0.75 ±0.14 ) mmol/L vs.( 1.52 ±0.88 ) mmol/L, P<0.05;(2.21 ±0.78)mmol/L vs.(4.55 ±1.12)mmol/L, P<0.05;(1.76 ±0.31)mmol/L vs.(2.23 ±0.77) mmol/L, P<0.05; (1.15 ±0.34) vs.(1.52 ±0.41) mmol/L, P<0.05.The liver enzymes creatine kinase in intensive group was not significantly changed , but the creatinine levels decreased (82.53 ±23.85)μmol/L vs.(57.81 ±15.27) μmol/L, P<0.05, and the blood homocysteine and ultra-sensitivity C-reactive protein levels also decreased compared with the baseline ( 10.52 ±4.66 ) mmol/L vs.(30.70 ±18.82 ) mmol/L, P <0.05;( 8.06 ±2.68 ) mg/L vs.( 19.75 ±11.91 ) mg/L, P <0.05. Conclusions Short-term intensive statin therapy can effectively reduce blood lipid , cholesterol and homocysteine levels and raise HDL cholesterol levels; also with its anti-inflammatory and renal protective effect the therapy can provide more clinical benefit for patients with ACS .