急诊大剂量阿托伐他汀降脂治疗急性冠脉综合征对血清炎性因子的影响

巨振兴

（咸阳市中心医院，陕西 咸阳，712000）

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摘要：

目的 探讨急诊大剂量阿托伐他汀降脂治疗急性冠脉综合征对血清炎性因子的影响。方法 将于我院就诊的78 例急性 冠脉综合征患者随机分为观察组与对照组，各39 例。两组均采取常规治疗，在此基础上，观察组给予大剂量（40 mg/d）阿托伐 他汀治疗，对照组给予小剂量（20 mg/d）阿托伐他汀治疗。治疗8 周后对比两组用药前、后IL-6、hs-CRP、TNF-α 等炎症因子 水平、血脂水平及不良反应发生率。结果 治疗后，两组IL-6、hs-CRP、TNF-α 水平均低于治疗前，且观察组低于对照组（P<0.05）。治 疗后，观察组TC、TG、LDL-C 显水平显著低于对照组（P<0.05)。两组不良反应总发生率比较，差异无统计学意义（P>0.05）。结论 急诊大剂量阿托伐他汀治疗急性冠脉综合征可有效发挥调脂作用，显著降低血清炎症因子水平，安全性高，具有良好的临 床应用价值。

关键词：大剂量；阿托伐他汀；急性冠脉综合征；炎性因子

中图分类号：R451.4文献标志码：A文章编号：2096-1413(2017)36-0024-02

Effect of emergency high-dose atorvastatin on serum inflammatory factors in patients with acute coronary syndrome
JU Zhen-xing
(Xianyang Central Hospital, Xianyang 712000, China)

ABSTRACT: Objective To investigate the effect of high-dose atorvastatin on serum inflammatory factors in patients with acute coronary syndrome (ACS). Methods A total of 78 patients with acute coronary syndrome in our hospital were randomly divided into observation group and control group, with 39 cases in each group. All patients were treated with conventional therapy, on this basis, the observation group was given high-dose (40 mg/d) atorvastatin treatment, and the control group was given low-dose (20 mg/d) atorvastatin treatment. Both groups were treated for 8 weeks. The levels of serum inflammatory factors such as IL-6, hs-CRP, TNF-α, and levels of serum lipid, the incidences of adverse reactions were compared between the two groups. Results After treatment, the levels of IL-6, hs-CRP and TNF-α in the two groups were lower than those before treatment, and those in the observation group were lower than the control group (P<0.05). After treatment, the levels of TC, TG and LDL-C in the observation group were significantly lower than those in the control group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion Emergency high -dose atorvastatin in patients with acute coronary syndrome can effectively play the role of lipid -lowering, and significantly reduce the levels of serum inflammatory factors, with high safety, which has good clinical application value.

KEYWORDS: high-dose; atorvastatin; acute coronary syndrome; inflammatory factor

参考文献：
[1] 肖学慧,陈照宇,刘艳阳,等.炎性因子与冠脉斑块易损性的研究进 展[J].内蒙古医科大学学报,2015,37(杂1):173-176,182.
[2] 刘晓霞.阿托伐他汀对冠心病患者血脂指标及一氧化氮、高敏C 反 应蛋白、血管内皮功能的影响[J].海军医学杂志,2016,37(3):262-263.
[3] 师树田,聂绍平.2015ESC 非ST 段抬高型急性冠脉综合征管理指 南解析[J].中国心血管病研究,2016,14(2):116-118.
[4] 李侠,胡有东,张枫林,等.老年冠状动脉粥样硬化性心脏病患者冠 状动脉病变影响因素的探讨[J].中华损伤与修复杂志电子版,2016,11(3):204-211.
[5] 杨朝美,李逊,马珍.血清BNP、hs-CRP、IMA 与冠状动脉粥样硬化性 心脏病患者的相关性研究[J].中国实验诊断学,2015,19(7):1077-1079.
[6] 郭恩会,路青山,杨霄鹏,等.阿托伐他汀对大鼠颈动脉粥样硬化易 损斑块及hs-CRP 和MMP-9 表达的影响[J].中风与神经疾病,2016,33(4):307-310.
[7] 华先平,王贤明,谢建,等.肿瘤坏死因子-琢 基因G-238A 多态性与 冠状动脉疾病相关性的Meta 分析[J].中国循证心血管医学杂志,2015,8(1):23-26.
[8] 于辉月,叶龙英,吴自强,等.2 型糖尿病合并急性冠状动脉综合征 hs-CRP、IL-6 和HbA1c 的变化及相关性[J].疑难病杂志,2015,14(3):227-229.
[9] 王康,徐亚伟,彭文辉,等.心血管疾病在他汀类药物多效性中的获 益[J].现代生物医学进展,2015,15(16):3149-3153.
[10] 宋予苹,王文君.不同剂量阿托伐他汀治疗老年急性冠脉综合征 疗效观察[J].现代中西医结合杂志,2016,25(26):2924-2926.