不同服药时间对辛伐他汀调脂及抗炎效应的影响  

Effects of Morning Versus Evening Administration of Simvastatin on Lipid-Lowering and Anti-Inflammatory Properties

作　　者：陈红[1] 任景怡[1] 武蓓[1] 刘昕[1] 郭志红[1] 

机构地区：[1]北京大学人民医院心内科,北京市100044

出　　处：《中国动脉硬化杂志》2006年第12期1045-1048,共4页Chinese Journal of Arteriosclerosis

摘　　要：目的比较晨起及晚间顿服常用剂量辛伐他汀对混合性高脂血症患者的调脂作用以及抗炎效应的差异。方法103例混合性高脂血症患者随机分为晨起服药组(n=52)及晚间服药组(n=51),均口服20 mg辛伐他汀,疗程6个月。观察治疗前后主要血脂参数的变化率和达标率、超敏C反应蛋白浓度变化及不良反应。结果与治疗前相比,不同时间服药均能明显降低患者血清总胆固醇、低密度脂蛋白胆固醇和甘油三酯水平(P<0.001);两组相比较,晨起服药组降低甘油三酯的幅度明显优于晚间服药组(38%比19%,P=0.035),其降低总胆固醇和低密度脂蛋白胆固醇的作用虽略低于晚间服药组,但仍可使两者分别下降21%和31%。按我国“血脂异常防治建议”的目标,晨起服药组甘油三酯的达标率更高(51%比33%,P=0.038),且三项(总胆固醇、低密度脂蛋白胆固醇和甘油三酯)全部达标者也明显优于晚间服药组(36%比29%,P<0.05);而低密度脂蛋白胆固醇的达标率晚间服药组高于晨起服药组。不同时间服药均能明显降低血清超敏C反应蛋白水平,两组间比较差异无显著性(P>0.05)。结论与传统的晚间服药相比,晨起服药可更有效降低血清甘油三酯水平,调节轻中度混合性高脂血症患者的血脂异常。并且同晚间服药一样具有显著的抗炎作用。Aim To compare the effects of morning versus evening intake of simvastatin on lipid profile and high-sensitivity C-reactlve protein （hs-CRP） in patients with combined hyperlipidemia. Methods 103 patients were randomly assigned to receive 20 mg simvastatin orally each morning （ n = 52） or evening （ n = 51 ）. The treatment period lasted 6 months. Lipid profiles, physical and laboratory investigations for adverse effects, and hs-CRP were assessed. Results Serum total cholesterol （TC）, low density lipoprotein cholesterol （LDLC） and triglyeeride （TG） levels decreased significantly in both treatment groups, while siravastatin in the morning administration resulted in larger reductions in TG than dose evening administration （38% vs 19%, P = 0.035）. Moreover, morning administration reduced TC and LDLC by 21% and 31%, respectively. The success rates of TG and all three together （TC, LDLC and TG） were 51% and 36% in the rooming administration, which were superior to the drug given in the evening （33% and 29%, respectively）. Although serum hs-CRP levels decreased significantly from baseline in both rooming and evening administration, similar hs-CRP reductions were observed between the two treatment groups （ P 〉 0.05）. And the effects were cholesterol-independent. There were no adverse events during the treannent periods, and simvastatin was well tolerated in the morning or evening administration. Conclusions The results demonstrated that TG lowering effects of simvastatin in the morning administration were superior to that of evening administration. There is no diurnal variation in anti-inflammatory effects of this drug, therefore, morning or evening administration is equally effective in decreasing hsCRP.

关 键 词：内科学 辛伐他汀 超敏C反应蛋白 混合性高脂血症 甘油三酯 总胆固醇 低密度脂蛋 白胆固醇 

分 类 号：R5[医药卫生—内科学]