急性冠脉综合征早期应用辛伐他汀临床探究.doc

急性冠脉综合征早期应用辛伐他汀临床探究[摘要] 目的 探讨急性冠脉综合征(ACS)早期应用辛伐他汀的有效性和安全性。方法 对916例急性冠脉综合征患者入院24小时内给予辛伐他汀20mgqn.平均住院时间为(16.56±1.92)天。比较用药前、出院时血脂、高敏C反应蛋白、肝功能变化情况以及住院期间缺血事件发生率。 结果1 治疗后总胆固醇(TC)、LDL-C、hs-CRP均较前明显降低,高密度脂蛋白升高,差异有统计学意义。其中LDL-C由(3.62±1.01)mmol/L降至(2.30±1.96)mmol/L,高密度脂蛋白胆固醇(HDL-C)由(1.43±0.41)mmol/L升至(1.64±1.59)mmol/L。2hs-CRP从(48.89±51.20)mmol/L降至(7.98±18.56)mmol/L,p120U/L有51例(5.57%),AST120U/L有49例(5.35%),均予辛伐他汀减半治疗。有2例因转氨酶达正常值5倍以上停用,停用后很快恢复正常。缺血事件发生31例(3.8%) 结论 急性冠脉综合征早期应用辛伐他汀可以明显降低血脂、hs-CRP和缺血事件发生率且安全可靠. [关键词] 急性冠脉综合征;辛伐他汀;有效性和安全性 [中图分类号] R969.4[文章标识码]A[文章编号] Clinical features of simvastatin therapy in patients with acute conoarysyndrome WANG Qing-yuan Department of Cardiology ,Central Hospital ofChina Railway Erju ,Chengdu 610031,China [Abstract]ObjectiveTo assess the safety and efficacy of simvastatinin patients with acute conoarysyndrome. Methods A total of 916 patients with ACSwere assigned to simvastatin 20mg daily within 24 hours.The mean hospitalization was (16.56±1.92)days.Lipidprofiles, hs-CRP,liver enzyme leveland incidence ofischemic events were observed.Result 1 The levels of serum lipids and hs-CRP significantly decreased,HDL-C increased clearly .LDL-Cwascontinuously decreased[(3.62±1.01)mmol/L at admission , (2.30±1.96)mmol/L at discharge.HDL-C increased from (1.43±0.41)mmol/L to (1.64±1.59)mmol/L.2 high-sensitivity C-reactive protein level decreased from(48.89±51.20)mmol/L to (7.98±18.56)mmol/L,p120U/L were found in 51(5.57%),AST120/L were found in 49(5.35%).Give half the treatment effect of simvastatin to them. Two cases have reached the normal value due to transaminase 5 times more to stop simvastatin use. Out soon after the resumption of normal. 31 cases of ischemic events(3.8%).ConclusionIntensive simvastatin therapy with a dose of 20mg daily is safe and effective for patients withACS. [Key words] Acute conoarysyndrome; Simvastatin; Treatmentoutcome 急性冠脉综合征(acute coronary syndrome,ACS)是以急性心肌缺血为共同特征的一组临床综合征,包括不稳定型心绞痛(UA)、非ST段抬高心肌