發(fā)布時(shí)間：2018-04-18 15:36

  本文選題：急性冠脈綜合征 + 瑞舒伐他汀�。� 參考：《中國藥房》2017年11期

【摘要】：目的:觀察急性冠脈綜合征(ACS)患者接受強(qiáng)化劑量瑞舒伐他汀治療的遠(yuǎn)期療效,并探討其可能機(jī)制,為臨床診療提供參考。方法:將我院2013年1月-2015年1月臨床治愈后接受瑞舒伐他汀治療的ACS患者102例,按照瑞舒伐他汀劑量的不同分為觀察組和對(duì)照組,其中觀察組55例,對(duì)照組47例。兩組患者均在同一組醫(yī)師的指導(dǎo)下,在常規(guī)治療的基礎(chǔ)上接受瑞舒伐他汀鈣片治療,觀察組劑量為20 mg,qd,po,對(duì)照組為10 mg,qd,po。兩組患者均治療1年。比較兩組患者1年主要心臟事件(MACE)累積發(fā)生率、治療前及治療3個(gè)月后血脂水平、血清細(xì)胞因子水平及不良反應(yīng)發(fā)生情況。結(jié)果:觀察組患者1年內(nèi)MACE累積發(fā)生率顯著低于對(duì)照組患者,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療后,兩組患者總膽固醇(TC)及低密度脂蛋白膽固醇(LDL-C)水平均較治療前顯著降低,高密度脂蛋白膽固醇(HDL-C)水平較治療前顯著升高,且觀察組LDL-C水平顯著低于對(duì)照組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。治療后,兩組患者血清白細(xì)胞介素1β(IL-1β)及腫瘤壞死因子α(TNF-α)水平均較治療前顯著降低(P0.05),且觀察組顯著低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。觀察組患者治療后外周血LDL-C與IL-1β、TNF-α均呈現(xiàn)顯著正相關(guān)關(guān)系,有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組患者不良反應(yīng)發(fā)生率比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:強(qiáng)化劑量瑞舒伐他汀治療可顯著改善ACS患者的遠(yuǎn)期預(yù)后,這可能與其調(diào)控脂質(zhì)代謝及抗炎作用有關(guān)。
[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- 偽 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- 偽 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.
【作者單位】： 天津中醫(yī)藥大學(xué)第一附屬醫(yī)院急癥部;
【分類號(hào)】：R541.4

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