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目的:观察早期应用辛伐他汀强化治疗对急性冠状动脉综合征(ACS)患者血小板氧化低密度脂蛋白内皮受体-1(LOX-1)表达和近期预后的影响。方法:87例ACS患者随机分为A、B组,A组患者在常规药物治疗基础上早期给予辛伐他汀20mg/晚,B组患者在常规药物治疗基础上早期给予辛伐他汀60mg/晚,入院后次日及1周后采血检测肝肾功能、血糖、血脂、血小板聚集功能、血小板LOX-1的表达,观察入院后30d内主要心血管事件。结果:治疗后2组患者血小板LOX-1水平均有明显下降,B组下降更明显,2组比较差异有统计学意义(2.91±0.65∶2.61±0.51,P<0.05)。治疗后2组患者血小板聚集功能均有明显下降,B组降低更明显,2组比较差异有统计学意义(34.2±11.1∶29.4±7.7,P<0.05)。B组较A组30d内主要心血管事件发生更低。结论:早期强化他汀类药物治疗ACS患者短期内能抑制血小板功能,改善患者的近期预后,这可能与抑制血小板LOX-1的表达有关。
OBJECTIVE: To observe the effect of early application of simvastatin on the expression of platelet LOX-1 and its prognosis in patients with acute coronary syndrome (ACS). Methods: A total of 87 patients with ACS were randomly divided into A and B groups. The patients in group A were given simvastatin 20 mg / night on the basis of routine drug treatment. The patients in group B were given simvastatin 60 mg / Liver and kidney function, blood glucose, blood lipid, platelet aggregation function and platelet LOX-1 expression were detected by blood sampling on the next day and one week after admission. The main cardiovascular events within 30 days after admission were observed. Results: After treatment, the level of LOX-1 in platelets decreased significantly in both groups. The decrease in group B was more obvious. There was significant difference between the two groups (2.91 ± 0.65:2.61 ± 0.51, P <0.05). After treatment, platelet aggregation was significantly decreased in both groups, and the decrease in group B was more obvious. The difference between the two groups was statistically significant (34.2 ± 11.1: 29.4 ± 7.7, P <0.05). The incidence of major cardiovascular events in group B was lower than that in group A within 30 days. Conclusion: Early intensive statin treatment of patients with ACS can inhibit platelet function and improve the short-term prognosis in short-term, which may be related to the inhibition of platelet LOX-1 expression.