目的观察急性冠脉综合征早期(24～48h)应用不同剂量的辛伐他汀的临床疗效及安全性。方法选择临床确诊为ACS的患者110例,随机分为20mg组和40mg组,每晚服药1次,观察1、3个月的血脂和高敏C-反应蛋白,随访3个月内不良反应及心脏事件的发生情况。结果(1)两组服药后1、3个月的总胆固醇、甘油三脂、低密度脂蛋白、胆固醇hs-CRP均明显降低,心脏事件发生率也明显减少,且40mg组作用明显优于20mg组。(2)两组均无严重不良反应。结论ACS患者住院早期应用辛伐他汀可明显降低血脂,降低炎症因子,减少心脏事件的发生,40mg作用明显优于20mg。 Objective To observe the clinical efficacy and safety of different doses of simvastatin in patients with acute coronary syndrome (24-48h). Methods One hundred and ten patients with clinically diagnosed ACS were randomly divided into 20 mg and 40 mg groups. The patients were given once a night for 1 and 3 months. The blood lipid and high-sensitivity C-reactive protein were observed at 1 and 3 months. The adverse reaction and heart were followed up for 3 months. The occurrence of the incident. Results (1) The levels of total cholesterol, triglyceride, low density lipoprotein, cholesterol and hs-CRP were significantly decreased and the incidence of cardiac events were significantly decreased in both groups at 1 and 3 months after treatment, and the effect of 40mg was significantly better than that of 20mg group. (2) There was no serious adverse reaction in both groups. Conclusions Early use of simvastatin in hospitalized patients with ACS can significantly lower blood lipids, reduce inflammatory cytokines and reduce the incidence of cardiac events. The effect of 40 mg is better than 20 mg.