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目的探讨阿托伐他汀强化治疗短期内对急性冠脉综合征(ACS)患者血浆B型钠尿肽(BNP)及血脂的影响。方法将入院后24h内予常规治疗(溶栓剂、抗凝剂、ACEI、β受体阻滞剂、钙通道拮抗剂、硝酸酯类等)的46例ACS患者随机分为常规治疗组和强化治疗组。正常体检者23例为对照组,观察治疗前及治疗5d后检测血浆BNP、血脂。结果常规治疗组与强化治疗组ACS患者入院治疗前后的血脂TC、TG、HDL及LDL-C水平无差别(P>0.05)。常规治疗组与强化治疗组患者治疗前血浆BNP较对照组明显增高(P<0.01),治疗5d后,常规治疗组及强化治疗组血浆BNP水平有差别(P<0.01),且强化治疗组更为显著(P<0.01)。结论 ACS急性发病期存在心功能障碍;阿托伐他汀强化及常规短期治疗对ACS患者均能降低血浆BNP水平;这种作用独立于降脂作用,可能与剂量有关。
Objective To investigate the effects of atorvastatin on plasma B-type natriuretic peptide (BNP) and serum lipids in patients with acute coronary syndrome (ACS) in the short term. Methods Forty-six patients with ACS who underwent routine treatment (thrombolytic agents, anticoagulants, ACEI, beta-blockers, calcium channel blockers, nitrates, etc.) within 24 hours after admission were randomly divided into routine treatment group and intensive therapy group. 23 cases of normal physical examination as a control group, before treatment and after treatment 5d plasma BNP, blood lipids were detected. Results There was no significant difference in the levels of TC, TG, HDL and LDL-C before and after admission to ACS patients in routine therapy group and intensive therapy group (P> 0.05). Plasma BNP levels were significantly higher in the conventional treatment group and intensive treatment group than those in the control group before treatment (P <0.01). After 5 days of treatment, plasma BNP levels were significantly different between the conventional treatment group and the intensive treatment group (P <0.01) As significant (P <0.01). Conclusions There is cardiac dysfunction in the acute stage of ACS. Both atorvastatin and conventional short-term treatment can decrease plasma BNP level in patients with ACS. This effect is independent of lipid-lowering effect and may be dose-dependent.