急性冠脉综合征患者接受强化剂量瑞舒伐他汀治疗的临床观察

发布时间：2018-04-18 15:36

本文选题：急性冠脉综合征 + 瑞舒伐他汀　；参考：《中国药房》2017年11期

【摘要】：目的:观察急性冠脉综合征(ACS)患者接受强化剂量瑞舒伐他汀治疗的远期疗效,并探讨其可能机制,为临床诊疗提供参考。方法:将我院2013年1月-2015年1月临床治愈后接受瑞舒伐他汀治疗的ACS患者102例,按照瑞舒伐他汀剂量的不同分为观察组和对照组,其中观察组55例,对照组47例。两组患者均在同一组医师的指导下,在常规治疗的基础上接受瑞舒伐他汀钙片治疗,观察组剂量为20 mg,qd,po,对照组为10 mg,qd,po。两组患者均治疗1年。比较两组患者1年主要心脏事件(MACE)累积发生率、治疗前及治疗3个月后血脂水平、血清细胞因子水平及不良反应发生情况。结果:观察组患者1年内MACE累积发生率显著低于对照组患者,差异有统计学意义(P0.05)。治疗后,两组患者总胆固醇(TC)及低密度脂蛋白胆固醇(LDL-C)水平均较治疗前显著降低,高密度脂蛋白胆固醇(HDL-C)水平较治疗前显著升高,且观察组LDL-C水平显著低于对照组,差异均有统计学意义(P0.05)。治疗后,两组患者血清白细胞介素1β(IL-1β)及肿瘤坏死因子α(TNF-α)水平均较治疗前显著降低(P0.05),且观察组显著低于对照组,差异有统计学意义(P0.05)。观察组患者治疗后外周血LDL-C与IL-1β、TNF-α均呈现显著正相关关系,有统计学意义(P0.05)。两组患者不良反应发生率比较,差异无统计学意义(P0.05)。结论:强化剂量瑞舒伐他汀治疗可显著改善ACS患者的远期预后,这可能与其调控脂质代谢及抗炎作用有关。
[Abstract]:Objective: to observe the long-term effect of intensive dose of resuvastatin in patients with acute coronary syndrome (ACS), and to explore its possible mechanism, and to provide reference for clinical diagnosis and treatment.Methods: 102 ACS patients who were cured from January 2013 to January 2015 were divided into observation group (n = 55) and control group (n = 47) according to the dosage of resuvastatin.Under the guidance of the same group of physicians, both patients were treated with rosuvastatin calcium tablets on the basis of routine treatment. The dosage of the observation group was 20 mg / kg QD group and the control group was 10 mg / g QD group.Both groups were treated for 1 year.The cumulative incidence of major cardiac events in one year, serum lipid levels, serum cytokines and adverse reactions were compared between the two groups before and 3 months after treatment.Results: the cumulative incidence of MACE in the observation group was significantly lower than that in the control group (P 0.05).After treatment, the levels of total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) in both groups were significantly lower than those before treatment, and the levels of HDL-C in high density lipoprotein cholesterol (HDL-C) were significantly higher than those before treatment, and the levels of LDL-C in the observation group were significantly lower than those in the control group.The difference was statistically significant (P 0.05).After treatment, the serum levels of IL-1 尾 and TNF- 伪 in the two groups were significantly lower than those before treatment, and the levels in the observation group were significantly lower than those in the control group (P 0.05).There was a significant positive correlation between peripheral blood LDL-C and IL-1 尾 TNF- 伪 after treatment in the observation group (P 0.05).There was no significant difference in the incidence of adverse reactions between the two groups (P 0.05).Conclusion: the long-term prognosis of patients with ACS can be significantly improved by intensive dose of Risuvastatin, which may be related to the regulation of lipid metabolism and anti-inflammatory effects.
【作者单位】：天津中医药大学第一附属医院急症部;
【分类号】：R541.4

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