不同剂量阿托伐他汀对急性冠脉综合征患者炎症及血小板和纤溶活性的影响  

Effects of Different Dosage of Atorvastatin on Inflammation,Platelet Activity and Fibrinolytic Activity in Patients with Acute Coronary Syndrome

作　　者：林毅[1] 陈新民[2] 罗助荣[1] 盖晓波[1] 

机构地区：[1]南方医科大学福州总医院临床医学部心内科,福建省福州市350025 [2]南方医科大学福州总医院临床医学部儿科,福建省福州市350025

出　　处：《中国全科医学》2007年第13期1060-1062,共3页Chinese General Practice

摘　　要：目的观察冠脉综合征(ACS)患者应用不同剂量(10mg、20mg、40mg)阿托伐他汀治疗前后外周血中总胆固醇(TC)、超敏C-反应蛋白(hs-CRP)、白介素-6(IL-6)、血小板血栓烷B2(TXB2)、血小板α-颗粒膜蛋白-140(GMP-140)、纤溶酶原激活物抑制剂(PAI-1)水平、组织型纤溶酶原激活剂(t-PA)活性及肝功能的变化,探讨大剂量阿托伐他汀治疗ACS的疗效及安全性。方法ACS患者65例,在拜阿司匹林、氯吡格雷等基础治疗后随机分为3组,分别给予阿托伐他汀10mg/d、20mg/d、40mg/d,睡前服用。入院第1d、第14d抽取空腹静脉血16ml。测定hs-CRP、IL-6、TXB2、GMP-140、t-PA、PAI-1及TC、天门冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、肌酸激酶(CK)含量。采用SPSS13.0统计软件对检测结果的组间及治疗前后进行比较。结果3组患者TC、hs-CRP、IL-6、TXB2、GMP-140、PAI-1治疗后均有下降、t-PA活性上升;治疗后上述各指标3组间比较亦有差异;而3组治疗前后CK、ALT、AST组间比较无差异,治疗均后无显著上升。结论大剂量阿托伐他汀治疗ACS的疗效优于常规剂量,同时未增加药物的副作用。Objective To investigate the effect and safety of large dosage of Atorvastatin in treatment of acute coronary syndrome （ACS） through the change of total cholesterol （TC）, high sensitivity reactive protein （hs -CRP） , iterlieukin -6 （IL - 6） , Thromboxane B2 （ TXB2 ） , α - granule membrane protein - 140 （ GMP - 140 ） , plasminogen activator inhibitor - 1 （PAI - 1 ） level and tissue type plasminogen activator （ t - PA） activity in peripheral blood ; as well as the hepatic function of patients with ACS before and after treatment with different dosage of Atorvastatin. Methods Totally 65 cases of ACS patients were randomly divided as tree groups which were respectively given 10mg/d, 20mg/d, 40mg/d Atorvastatin before sleeping besides routine treatments of aspirin and clopidogrel. On the first day and 14th day of admission, 16 ml venous blood was taken for measuring hs- CRP, IL-6, TX B2, GMP- 140, t- PA, PAI- 1, TC and aspartate aminotransferase （AST） , alanine amiotransferase （ALT） , creatine kinase （CK）. SPSS 13.0 statistical software was used to compare the data before and after treatment. Results TC, hs-CRP, IL-6, TX B2, GMP-140, PAI-1 decreased significantly in all three groups, whilet-PAactivation increased remarkably. And after the treatment, there were significant differences among three groups on these items. But no visible statistic differences were found in CK, AST, and ALT among three groups. Conclusion Large dosage of Atorvastatin is better than routine dosage on treatment for ACS and of good safety.

关 键 词：冠心病 急性冠脉综合征 炎症反应 血小板活性 纤溶活性 阿托伐他汀 

分 类 号：R541.4[医药卫生—心血管疾病] R972.6[医药卫生—内科学]