郝建光

[摘要]目的 探讨早期大剂量应用阿托伐他汀治疗不稳定型心绞痛的临床疗效。 方法 选取2012年2月～2013年2月我院不稳定型心绞痛患者85例，按随机数字表法分为对照组（40例）和治疗组（45例）。两组均进行常规药物治疗，同时对照组给予阿托伐他汀10mg/d，治疗组给予阿托伐他汀20mg/d，并分别于治疗前后比较两组患者心血管事件发生率、血脂及超敏C反应蛋白（hs-CRP）水平。 结果 治疗7、15d后，治疗组hs-CRP水平均显著低于对照组，差异有统计学意义（P＜0.05）。并且治疗后30d，治疗组LDL-C及TC达标率均优于对照组。 结论 早期较大剂量应用阿托伐他汀可以显著降低不稳定性心绞痛患者的hs-CRP及血脂水平，对于降低心血管事件发生率及改善患者预后具有重要意义。

[关键词]不稳定型心绞痛；超敏C反应蛋白；阿托伐他汀

[中图分类号] R541.4   [文献标识码] B   [文章编号] 2095-0616（2014）11-69-03

The observation of unstable angina with atorvastatin in early phase and intensive therapy:an analysis of 45 cases

HAO Jianguang

Department of Cardiology, Tiexi District Center Hospital of Shenyang Province, Shenyang 110021, China

[Abstract] Objective To explore the clinical efficacy of atorvastatin in large dose on unstable angina. Methods From February 2012 to February 2013, 85 cases of unstable angina of our hospital were randomly divided into two groups: The control group (40 cases) and treatment group (45 cases). Both group were treated with normal medicine, at the same time, the control group were given atorvastatin 10 mg/d, while the treatment group were given Atorvastatin 20mg/d. Compare the incidence of cardiovascular events, blood lipids and hs-CRP level before and after treatment. Results The hs-CRP level of the control group was significantly lower than the treatment group(P＜0.05) after 7days and 15days treatment. And the target rate of LDL-C and TC of the treatment group were all improved after 30days. Conclusion Early and large dose application of atorvastatin can significantly reduce the level of hs-CRP and blood lipid of patients with unstable angina, which contributes to the incidence of cardiovascular events and plays an improve role in improving patients' prognosis.

[Key words] Unstable angina; Hs-CRP; Atorvastatin

不稳定型心绞痛（unstable angina，UA）属急性冠脉综合征（acute coronary syndrome，ACS）范畴，其急性期死亡较高[1-2]。鉴于目前我国医疗资源状况，临床上多采用药物治疗（如应用硝酸酯类、β受体阻滞剂、阿司匹林、他汀类药物及具有活血化瘀作用的中药等[3]。其中，阿托伐他汀是第三代他汀类药物，能够显著降低血脂、抑制粥样硬化斑块的炎症反映，稳定和消褪斑块。本文旨在探讨不同剂量的阿托伐他汀对于UA的临床疗效，现将结果报道如下。

1 资料与方法

1.1 一般资料

选取2012年2月～2013年2月来我院诊治的UA患者85例，对照组40例，年龄（54±11）岁；治疗组45例，年龄（53±14）岁。所有患者均符合中华医学会心血管病学会和中华心血管病杂志编辑委员会制定的《不稳定性心绞痛和非ST段抬高心肌梗死诊断与治疗指南》中的诊断标准[4]，排除急性心肌梗死、重度高血压、新发糖尿病、肿瘤以及严重肝、肾功能损伤和感染性疾病患者。……