目的：观察低剂量、负荷剂量的阿托伐他汀及负荷剂量的阿托伐他汀与氯吡格雷三种治疗方案对急性冠脉综合征患者血脂及 C -反应蛋白（CRP）和乳酸脱氢酶（LDH）的影响。方法将急性冠脉综合征患者117例分为低剂量组（20 mg/ d）、负荷剂量组（40 mg/ d）及负荷剂量联合组（40 mg/ d）+氯吡格雷组，各39例，治疗后4周比较三组患者的血脂、CRP、LDH 和载脂蛋白 A（Apo - A）水平。结果负荷剂量组患者血脂、CRP、LDH 水平降低明显优于低剂量组（ P ﹤0.05），联合用药组患者血脂、CRP、LDH 水平降低明显优于负荷剂量组（ P ﹤0.05），Apo - A 则呈升高趋势，联合用药组升高幅度最大。结论治疗急性冠脉综合征可优先选择负荷剂量（40 mg/ d）的阿托伐他汀；若条件允许，可在负荷剂量阿托伐他汀的基础上联合使用氯吡格雷，以改善治疗效果。%Objective To investigate the effects for lipids and C - reactive protein of low - dose,the loading dose of atorvastatin and a loading dose of atorvastatin and clopidogrel in treating acute coronary syndrome. Methods 117 patients with acute coronary syndrome were divid-ed into low - dose group(20 mg/ d),loading dose group(40 mg/ d)and loading dose group(40 mg/ d) + clopidogrel group. 39 patients were included into each group. After a treatment for four weeks,the blood lipids,C - reactive protein,lactate dehydrogenase and apolipoprotein levels were compared. Results The blood lipids,CRP,LDH levels of the patients in loading dose group were significantly lower than those of low -dose group( P ﹤ 0. 05). The blood lipids,CRP,LDH levels of the patients in combined treatment group were significantly lower than those of loading dose group( P ﹤ 0. 05). Apo - A increased and the sharpest increased in the combined treatment group. Conclusion In treatment of a-cute coronary syndrome,loading dose(40 mg/ d)of atorvastatin was preferred to choose. If condition is perfect,clopidogrel can be used on the basis of loading dose of atorvastatin to improve the therapeutic effect.
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