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目的:研究强化调脂对极高危冠心病患者治疗效果及预后的影响。方法:急性冠状动脉综合征患者80例,随机单盲分为强化组40例,常规组40例。强化组在常规治疗基础上服用辛伐他汀40mg,1次/d,3个月后若低密度脂蛋白胆固醇≥1.81mmol/L,则增至80mg/d;常规组在常规治疗基础上服用辛伐他汀20mg,1次/d,比较2组治疗前、治疗后1,3,6,12个月三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、高敏C反应蛋白及心脏事件的发生情况。结果:2组用药后三酰甘油、总胆固醇、低密度脂蛋白胆固醇水平均明显低于用药前(P<0.01),强化组优于常规组(P<0.05)。2组用药6月后血脂达标率比较强化组优于常规组,差异有统计学意义(P<0.01)。2组用药后高敏C反应蛋白水平均明显低于用药前(P<0.01),强化组优于常规组(P<0.05)。心脏事件发生率强化组低于常规组,差异有统计学意义(P<0.05)。结论:强化调脂可通过降低三酰甘油、总胆固醇、低密度脂蛋白胆固醇、高敏C反应蛋白,改善急性冠状动脉综合征患者血液流变学状态,改善心肌供血,抑制冠心病的发生、发展过程,安全有效。
Objective: To study the effects of intensive lipid-lowering therapy on treatment outcome and prognosis in patients with very high risk of coronary heart disease. Methods: A total of 80 patients with acute coronary syndrome were divided randomly into 40 cases in the intensive group and 40 cases in the conventional group. In the intensive group, 40 mg of simvastatin was given once a day on the basis of routine treatment, and increased to 80 mg / d if the LDL cholesterol was increased to 1.81 mmol / L after 3 months. In the conventional group, The rats in the two groups were treated with 20 mg of statin once a day for 3, 6, 12 months after treatment. The triglyceride, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, high-sensitivity C-reactive protein The occurrence of a heart attack. Results: The levels of triglyceride, total cholesterol and low density lipoprotein cholesterol in the two groups were significantly lower than those before treatment (P <0.01), and those in the intensive group were better than those in the conventional group (P <0.05). Two groups of drugs in June after lipid-lipid compliance rate was better than the conventional group, the difference was statistically significant (P <0.01). The levels of high-sensitivity C-reactive protein in the two groups were significantly lower than those before treatment (P <0.01), and those in the intensive group were better than those in the conventional group (P <0.05). The incidence of cardiac events was lower in the intensive group than in the conventional group, with significant difference (P <0.05). Conclusion: Intensive lipid-lowering can improve the blood rheology of patients with acute coronary syndrome by decreasing triglyceride, total cholesterol, low-density lipoprotein cholesterol and high-sensitivity C-reactive protein, improve myocardial blood supply, inhibit the occurrence and development of coronary heart disease Process, safe and effective.