摘要
目的探讨早期应用不同剂量阿托伐他汀对急性冠状动脉综合征患者血清sCD40L水平及其预后的影响。方法168例急性冠状动脉综合征患者随机分为阿托伐他汀小剂量(10mg/d,56例)、中剂量(40mg/d,55例)和大剂量(80mg/d,57例)组。测定治疗前后血清sCD40L和血脂水平。并随访(平均7.6±3.2个月)主要心血管事件。结果血清sCD40L水平在阿托伐他汀小剂量组治疗前后差异无显著性,而大、中剂量组治疗后分别降低52.4%和52.2%(P均<0.05);主要心血管事件发生率大、中剂量组比小剂量组分别减少29.1%和30.1%(P均<0.05),但大、中剂量组间差异无显著性。结论阿托伐他汀呈剂量依赖性通过抗炎作用稳定冠脉斑块,减少急性冠脉综合征患者心血管事件的发生,效应以中剂量(40mg/d)为佳。
Objective To explore the effects of early adminstering various doses of atorvastatin on serum sCD40L level and prognosis in patients with acute coronary syndrome (ACS). Methods One hundred and sixty-eight patients with ACS were randomly divided into three groups, which were administered atorvastatin at the dose of 10mg/d (low-dose group, n=56), 40mg/d (middle-dose group, n=55) and 80mg/d (high-dose group, n=57), respectively. Levels of serum sCD40L and lipid before and after treatment were measured. The major adverse cardiovascular events (MACE) were followed up for mean 7.6±3.2 months. Results The levels of serum sCD40L had no significant changes before and after treatment in low-dose group, but significantly reduced 52.4% and 52.2% in high-dose group and middle-dose group after treatment (P<0.05), respectively. Compared with low-dose group, the incidence of MACE reduced 29.1% and 30.1% in high-dose and middle-dose groups (P<0.05), respectively, but had no significant change between high-dose group and middle-dose group. Conclusion Atorvastatin could dose-dependently stabilize coronary plaques in patients with ACS via its anti-inflammation effects, and reduce the incidence of MACE. The administration of middle-dose (40 mg/d) of atorvastatin is reasonable.
出处
《中国医师杂志》
CAS
2005年第7期900-902,共3页
Journal of Chinese Physician