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目的:观察急性冠脉综合征患者初期予不同剂量阿托伐他汀短期治疗对一氧化氮、内皮素-1的影响,探讨急性冠脉综合征初期应用他汀类药物的必要性和有效性。方法:71例急性冠脉综合征患者随机分为阿托伐他汀40mg治疗组(26例)、阿托伐他汀20mg治疗组(25例)和常规治疗组(20例),测定治疗前后一氧化氮、内皮素-1的水平及血脂、肝功能等指标。结果:(1)3组病例治疗前后血脂各指标变化差异均无显著性(P>0.05)。(2)阿托伐他汀40mg治疗组和阿托伐他汀20mg治疗组治疗后3d的一氧化氮水平均明显升高,与治疗前比较有统计学差异(P<0.05),与对照组治疗后比较亦有统计学差异(P<0.05);与阿托伐他汀20mg治疗组比较,阿托伐他汀40mg治疗组治疗后3d的一氧化氮水平升高更明显,2组比较有统计学差异(P<0.05)。(3)内皮素-1水平3组患者治疗前后比较均无统计学差异(P>0.05)。结论:急性冠脉综合征初期予阿托伐他汀短期治疗,即可明显升高一氧化氮水平,对改善内皮功能有利,剂量偏大效果更明显。
OBJECTIVE: To observe the effect of short-term treatment of atorvastatin on nitric oxide and endothelin-1 in patients with acute coronary syndrome (ACS) at early stage and to investigate the necessity and effectiveness of initial statin use in patients with acute coronary syndrome. Methods: A total of 71 patients with acute coronary syndrome were randomly divided into atorvastatin 40 mg treatment group (26 cases), atorvastatin 20 mg treatment group (25 cases) and conventional treatment group (20 cases) Nitrogen, endothelin-1 levels and blood lipids, liver function and other indicators. Results: (1) There was no significant difference in the indexes of blood lipid between the three groups before and after treatment (P> 0.05). (2) The levels of nitric oxide in atorvastatin 40 mg group and atorvastatin 20 mg group were significantly higher than that before treatment (P <0.05), and after treatment with the control group (P0.05). Compared with atorvastatin 20 mg group, the level of nitric oxide in atorvastatin 40 mg group was more obvious than that of atorvastatin 20 mg group (P <0.05). There was significant difference between the two groups P <0.05). (3) There was no significant difference in the levels of endothelin-1 between the three groups before and after treatment (P> 0.05). Conclusion: Short-term treatment with atorvastatin in the early stage of acute coronary syndrome can significantly increase the level of nitric oxide, which is beneficial to improve the endothelial function.