目的 观察冠状动脉支架术后辛伐他汀强化降脂对冠心病(CHD)患者脂蛋白(a)(LP(a))水平及支架内再狭窄(ISR)风 险的影响。方法 选择2016年1月至2017年6月我院心内科CHD行冠状动脉支架术后患者100例，随机分为强化组50人 与对照组50人，对照组口服辛伐他汀20mg/d，强化组口服辛伐他汀40mg/d，观察用药半年后两组效果。结果 术后 用药半年，两组TC、TG、LDL-C、LP(a)水平均显著低于治疗前(P<0.05)，且强化组TC、TG、LDL-C、LP(a)改善程 度均优于对照组(P<0.05)；两组LVEF均显著高于术前(P<0.05)，LVEDD均显著低于术前(P<0.05)，且强化组LVEF、 LVEDD改善程度均优于对照组(P<0.05)；强化组ISR发生率6.00%，显著低于对照组的22.00%(P<0.05)。结论 CHD患 者行冠状动脉支架术后，给予辛伐他汀强化降脂，能降低患者血脂水平及LP(a)水平，改善患者心功能，降低ISR发 生率，且无显著不良反应。

Objective To observe the effect of aggressive lipid-lowering therapy with simvastatin on the lipoprotein (a)(LP(a)) level and the risk of in-stent restenosis(ISR)in coronary heart disease(CHD)patients after coronary stent implantation. Methods From January 2016 to June 2017, 100 CHD patients with coronary stent implantation in our department of Cardiology were taken as the research objects, and they were randomly divided into strengthened group (50 cases) and control group (50 cases). The control group was treated with oral simvastatin 20mg/d, while the strengthened was treated with oral simvastatin 40mg/d. Six months after treatment, the effects of the two groups were observed and compared. Results Six months after treatment, the TC, TG, LDL-C and LP (a) levels in the two groups were significantly lower than those before treatment (P<0.05), and the improvements of TC, TG, LDL-C and LP (a) in the strengthened group were better than those in the control group (P<0.05); the LVEF levels in the two group were significantly higher than those before operation (P<0.05), the LVEDD levels in the two groups were significantly lower than those before operation (P<0.05), and the improvements of LVEF and LVEDD in the strengthened group were better than those in the control group (P<0.05); the incidence rate of ISR in the strengthened group was 6.00% which was significantly lower than that in the control group 22.00% (P<0.05). Conclusion Aggressive lipid-lowering therapy with simvastatin, which has no obvious adverse reactions, can reduce the levels of serum lipid and LP (a), improve the cardiac function of patients and reduce the incidence rate of ISR for CHD patients after coronary stent implantation.