标题：早期强化阿托伐他汀治疗对急性冠脉综合征患者血清脂联素与血脂水平的影响

      作者：陈楚纯
    (珠海市第五人民医院内科，广东 珠海 519020)

      卷次： 2014年25卷6期

      【摘要】 目的 观察急性冠脉综合征早期强化阿托伐他汀治疗的临床疗效。方法 选择我院收治的急性
冠脉综合征患者96例，随机分为研究组和对照组，每组48例。两组患者均给予溶栓、抗凝及抗血小板药物等常规治
疗，研究组患者口服阿托伐他汀40 mg/d，对照组患者口服阿托伐他汀10 mg/d，疗程1个月。观察两组患者治疗前、
治疗后24 h、72 h、1周及1个月血脂、血清脂联素(APN)和超敏C反应蛋白(hs-CRP)水平，随访6个月，观察两组患者
的心血管事件发生率及药物不良反应。结果 治疗前两组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇
(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、APN及hs-CRP水平比较差异无统计学意义(P>0.05)。治疗后72 h开始两
组APN水平较治疗前明显升高，hs-CRP水平较治疗前明显降低(P<0.05)，治疗后72 h研究组LDL-C水平较治疗前
明显降低(P<0.05)，治疗72 h、1周、1个月研究组血清APN明显高于对照组，hs-CRP水平明显低于对照组(P<0.05)，
治疗1个月研究组LDL-C、TC明显低于对照组(P<0.05)。6个月内研究组心血管事件发生率明显低于对照组(P<
0.01)。两组治疗期间均无严重不良反应发生。结论 早期强化阿托伐他汀治疗可以有效降低患者血脂水平，减少
近期心血管事件发生，其作用可能与阿托伐他汀提高血清脂联素水平，降低炎症反应有关。

      【关键词】 急性冠脉综合征；阿托伐他汀；脂联素；心血管事件

      【中图分类号】 R541.4 【文献标识码】 A 【文章编号】 1003—6350（2014）06—0810—03


Effect of early intensive atorvastatin treatment on serum adiponectin and blood lipid level in patients with
acute coronary syndrome.
CHEN Chu-chun. Department of Internal Medicine, the Fifth People's Hospital of Zhuhai
City, Zhuhai 519020, Guangdong, CHINA

【Abstract】 Objective To study the effect of early intensive atorvastatin treatment for acute coronary syn-
drome. Methods Ninety-six patients of acute coronary artery in our hospital were randomly divided into the study
group and the control group, with 48 cases in each group. Patients in the study group received atorvastatin 40 mg/d,
and patients in the control group received atorvastatin 10 mg/d, both for 1 month. The blood lipid, serum adiponectin
(APN), and high sensitivity C reactive protein (hs-CRP) levels were observed before treatment, and 24 h, 72 h, 1 week
and 1 month after treatment. The incidence of cardiovascular events and adverse drug reactions were observed during
the follow-up of 6 months. Results Before treatment, the two groups showed no statistically significant difference in
total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein choles-
terol (HDL-C), APN and hs-CRP levels (P>0.05). 72 h after treatment, the APN levels of two group was significantly
higher than before treatment, the level of hs-CRP was significantly lower (P<0.05), and the level of LDL-C were sig-
nificantly lower (P<0.05). 72 h, 1 week, 1 month after treatment, serum APN of the study group was significantly high-
er than that of the control group, the level of hs-CRP was significantly lower than the control group (P<0.05). One
month after treatment, the LDL-C, TC levels were significantly lower in the study group than the control group (P<
0.05). The incidence of cardiovascular events in the study group was significantly lower than the control group (P<
0.01). There were no serious adverse reactions in the two groups during the follow-up. Conclusion Early intensive
atorvastatin therapy can effectively decrease the blood lipid levels, and reduce the incidence of cardiovascular events.
The effects may be related to the fact that atorvastatin increases serum adiponectin levels and reduces inflammation.

      【Key words】 Acute coronary syndrome; Atorvastatin; Adiponectin; Cardiovascular events