目的探讨早期应用负荷剂量阿托伐他汀对血脂正常的急性非ST段抬高型心肌梗死(non-ST-segment elevation acut myocardial infarction,NSTEMI)患者的临床疗效及安全性。方法将血脂正常的NSTEMI患者65例,随机分为阿托伐他汀负荷剂量组(A组)33例及常规剂量组(B组)32例,A组给予阿托伐他汀钙片40 mg/d,口服;B组给予阿托伐他汀钙片20 mg/d,口服。分别于治疗前及治疗2周后测定血脂、高敏C-反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、血清脂联素(adiponectin,APN)、肝功能,并且随访6个月,统计严重心血管不良事件(major adverse cardiovascular events,MACE)发生情况。结果与常规剂量组比较,负荷剂量组的总胆固醇(total cholesterol,TCH)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、hs-CRP下降更明显,APN较高,且两组肝功能无明显损害。6个月随访,负荷剂量组的MACE发生率少于常规剂量组。结论血脂正常的NSTEMI患者早期应用负荷剂量阿托伐他汀钙片可使炎性反应明显减轻,稳定粥样斑块,并且改善预后。

Objective To ivsetigate the clinical effect and safety of early application of load dose of atorvastation to patients with non-ST-segment elevation acute myocardial infarction with nornal lipids. Methods A total of 65 patients who were diagnosed as having NSTEMI with nornal lipids were randomly divided into atorvastation load dose group (group A, n=33) and the conventional dose group (group B, n=32).Group A took 40 mg/d atorvastation in addition to routine treatment.Group B took 20 mg/d atorvastation.Blood lipids, high-sensitivity C-reactive protein(hs-CRP)and adiponectin(APN) levels, and liver functions were measured before treatment and after 2 weeks of treatment.Patients were followed up for 6 months. The incidence of major adverse cardiovascular events(MACE) were observed. Results The TCH,LDL-C and hs-CRP levels were decreased more obviously in group A after 2 weeks treatment (P＜0.05).while the APN levels were increased more obviously in group A(P＜0.05).Obvious liver dysfunctions were not found in both groups. After 6 months,the incidence of MACE was lower in group A than in group B. Conclusions In patients with NSTEMI, even with normal blood lipids,taking load dose of atorvastation early can reduce the inflammation response, improve the stabilization of atherosclerotic plaque and improve the prognosis.