【摘要】 目的研究两种剂量国产阿托伐他汀(阿乐)对介入治疗后的急性冠脉综合征(ACS)患者预后及血管内皮功能的影响。方法对97例行介入治疗后的 ACS 患者随机分为早期阿乐10mg/d(小剂量)和早期20 mg/d(大剂量)两个治疗组,1个月后根据血脂水平加减阿乐剂量。随访1年,比较两组患者血脂、内皮依赖性舒张功能(FMD)、NO、ET、总-氧化氮化合酶(NOS)、心源性死亡、急性心肌梗死、心绞痛复发、因不稳定型心绞痛住院等情况。结果治疗1、12个月时 TC、LDL-C 水平比治疗前显著降低,治疗1个月时大剂量组 TC、LDL-C 水平比小剂量组显著降低,大剂量组 NO、NO/ET 水平比治疗前显著提高。大剂量组比小剂量组1年内心绞痛复发和因不稳定心绞痛住院的发生明显减少(P<0.05)。治疗12个月时两组 FMD、TNOS 与治疗前相比均显著提高。结论早期强化降脂治疗可明显减少介入后 ACS 患者12个月内心绞痛复发和因不稳定心绞痛住院的发生率、改善患者介入治疗后 ACS 患者血管内皮功能。更多还原

【Abstract】 Objective To investigate the influence of two different dose of atorvastatin on the prognosis and endothelial function in post-PCI acute coronary syndrom patients.Methods 92 post-PCI ACS patients were randomly divided into two groups,atorvastatin 20mg and atorvastatin 10 mg group.In each group the patients were treated with atorvasta- tin 20mg or 10mg respectively.After one month we add or decrease the dose of atorvastatin according to the blood lipid level.After 12 month the blood lipid level、FMD、NO、ET、NOS、UAP、AMI were compared between two groups. Results The clinical setting have no significant association between two groups before treating,After treated 1 and 12 month the TC,LDL-C level were significantly decreased as compared with the base level before treating in each group. After treated 1 month,in atorvastatin 20 mg group the TC,LDL-C level were significantly decreased and NO、NO/ET level were significantly higher than those in atorvastatin 10 mg group.During 12 month follow up the incidence of angina pectoris onset and rehospitalization were significantly higher in atorvastatin 10 mg group(P<0.05 ),the FMD、TNOS level were significantly higher than those before treating.The FMD have a positive correlation to TNOS,r=0.1151,P =0.0499,Y=8.4039+00273 X.Conclusion The efficacy of 20mg atorvastatin is superior to that of 10mg atorvasta- tin in decreasing the incidence of angina pectoris onset and rehospitalization,improving FMD in post-PCI ACS patients. The FMD have positive correlation to TNOS.更多还原