早期应用大剂量普伐他汀对不稳定型心绞痛患者C-反应蛋白及纤溶活性的影响  

Effects of early and high dose pravastatin treatment on the C-reactive protein and fibrinolytic activity in patients with unstable angina pectoris(UAP)

作　　者：史卫国[1] 李武伦[1] 史文文[1] 王桂清[1] 

机构地区：[1]青岛市第八人民医院,山东青岛266100

出　　处：《中国急救医学》2004年第11期813-815,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的 探讨普伐他汀对不稳定型心绞痛(UAP)患者血清C-反应蛋白(CRP)水平及纤溶活性的影响。方法 52例UAP患者随机分为常规治疗组(25例)和普伐他汀治疗组(27例) 30例健康人为对照组 普伐他汀组于常规治疗基础上加用晋伐他汀40 mg／d,疗程为12周 各组分别于治疗前及结束时测定血清CRP、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白-胆固醇(HDL-C)、低密度脂蛋白-胆固醇(LDL-C)浓度、组织型纤溶酶原激活物(t-PA)和纤溶酶原激活物抑制物-1(PAI-1)活性。结果 普伐他汀组治疗12周后,CRP、TC、TG、LDL-C、PAI-1水平下降明显(P<0.05-P<0.01).t-PA明显升高(P<0.05)。常规组治疗前后则无显著性差异(P>0.05)。治疗前的UAP患者CRP与PAI-1活性呈正相关(P<0.01),与t-PA呈负相关(P<0.01) 普代他汀组治疗后CRP、PAI-1、t-PA与TC、LDL-C水平变化无相关关系 结论在UAP早期予以大剂量普代他汀治疗,可能有利于抑制炎症反应、改善内皮功能、提高纤溶活性、稳定斑块。Objective To explore the eftect of pravastatin on serum C-reactive protein and fibrinolytic aetivity abnormality in patients with unstable angina pectoris(UAP). Methods Fifty-two patients with UAP were randomly divided into routine treated group (25 cases) and pravastatin treated group(27 cases). 30 healthy subjects were taken as control. In the pravastatin group, pravastatin was given additionally by 40 mg/d. The therapeutic course was 12 weeks. Fasting serum total cholesterol(TC), triglyceride(TG), high density lipoprotein cholesterol (HDL C), low density lipoprotein cholesterol(LDL - C), C - reactive protein(CRP), tissue-type plasminogen activator(t - PA) and plasminogen activator inhibitor- 1(PAT-1) levels were measured before and after the treatments. Results Compared with healthy controls, the levels of CRP, TC, TG, LDL-C and PAI-1 were all higher(P < 0.05 - P < 0.01), t-PA was lower(P < 0.01) in patients with UAP. After pravastatin treatment, CRP, TC, TG, LDL- C and PAI - 1 were decreased, t-PA was increased more obviously in pravastatin group than before treatment(P <0.05-P <0.01), but there were no differences in routine group before and after treatment. Correlative analysis showed that CRP was positively correlated with PAI - 1 ( P < 0.01), inversely correlated with t - PA( P < 0.01) in patients with UAP More treatment; CRP, t-PA and PAI-1 were not correlated with TC, TC, HDL- C and LDL-C after pravastatin treatment(P >0.05, all). Conclusion Early and high - dose pravastatin treatment may be of great benefit to inhibiting inflammatory responses, improving endothelial function, increasing fibrinolytic activity and atherosclerotic plaque stabilization in patients with UAP.

关 键 词：普伐他汀 C-反应蛋白 纤溶活性 不稳定型心绞痛 

分 类 号：R541.4[医药卫生—心血管疾病]