不同剂量阿托伐他汀对ACS患者脂蛋白相关性磷脂酶A2的影响  

Effects of Different Doses of Atorvastatin on Lipoprotein-associated Phospholipase A2 in Patients with Acute Coronary Syndrome

作　　者：葛良清 

机构地区：[1]湖南省常德市第四人民医院心血管内科,湖南常德415000

出　　处：《医学临床研究》2010年第4期618-620,共3页Journal of Clinical Research

摘　　要：【目的】观察不同剂量阿托伐他汀对急性冠脉综合征（ACS）患者血浆脂蛋白相关性磷脂酶A2（Lp—PLA2）水平的影响。【方法】将46例ACS患者随机分为常规剂量组（常规治疗加阿托伐他汀20mg／d，23例）和强化治疗组（常规治疗加阿托伐他汀40mg／d，23例），治疗前及治疗10d后清晨空腹采血，以酶联免疫吸附法测定血浆中Lp—PLA2水平，并检测血脂各项指标；同时选用23例健康体检者作为正常对照。【结果】①ACS患者血浆LpPLA2水平明显高于正常对照组（P〈0．001）；②20mg／d和40mg／d阿托伐他汀治疗10d后Lp-PLA2水平较治疗前均有显著下降（P〈0．01），而强化治疗组下降更为明显（P〈0．01）；③spearman等级相关分析显示，ACS患者血浆Lp-PLA2水平与总胆固醇（TC）及低密度脂蛋白胆固醇（LDL—C）相关，与甘油三酯（TG）和高密度脂蛋白胆固醇（HDL—C）不相关。【结论】ACS患者血浆Lp—PLA2水平增高，短期阿托伐他汀治疗能降低ACS患者Lp-PLA2水平，且呈剂量依赖性。[Objective] To investigate the effects of different doses of atorvastatin on serum level of lipoprotein-associated phospholipase A2 （Lp-PLA2） in patients with acute coronary syndrome （ACS）. [Methods] Forty six patients with ACS were given routine therapy and randomized to routine dose group （20mg atorvastatin daily for 10 days, n =23） and high dose group （40mg atorvastatin daily for 10 days, n =23）. Serum levels of Lp-PLA2 before and after therapy were measured by enzyme-linked immunosorbent assay （ELISA）. Mean while, lipid profiles were tested as well. Twenty three healthy people were assigned to the control group. [Results]The serum level of Lp-PLA2 in patients with ACS was significantly higher than that in control group （ P 〈0. 001）. After 10 days treatment, the serum Lp-PLA2 level decreased significantly in both atorvastatin therapy groups （ P 〈0.01）. Moreover, the reduction was more notable in high dose group（ P 〈0.01）. The level of Lp PLA2 was related to the concentrations of total cholesterol （TC） and low density lipoprotein cholesterol （LDL-C）, but had no correlation with triglyceride （TG） or high density lipoprotein cholesterol （HDL-C） level. [Conclusion] The serum level of Lp-PLA2 is elevated in patients with ACS. Short-term atorvastatin therapy can decrease Lp-PLA2 level in such cases in a dose-dependent manner.

关 键 词：冠状动脉疾病/药物疗法 脂蛋白类 磷脂酶A类 降血脂药/投药和剂量 

分 类 号：R543.3[医药卫生—心血管疾病]