瑞舒伐他汀强化治疗对急性冠脉综合征血运重建术后血脂及C反应蛋白的影响  

Effects of rosuvastatin intensive therapy on blood lipid and C-reactive protein level in patients with acute coronary syndrome after percutaneous coronary intervention

作　　者：李书国[1,2] 邓娟娟[1,2] 朱慧铭[1,2] 韩琴[1,2] 朱正庭[1,2] 孔亚婷[1,2] 张丹[1,2] 潘希峰[1,2] 

机构地区：[1]三峡大学第一临床医学院 [2]湖北宜昌市中心人民医院老年病科,湖北宜昌443003

出　　处：《心血管康复医学杂志》2011年第4期377-380,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:评价瑞舒伐他汀强化治疗对急性冠脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术后血清低密度脂蛋白-胆固醇(LDL-C)和高敏C反应蛋白(hs-CRP)水平的影响。方法:60例ACS患者,随机分为瑞舒伐他汀强化治疗组(简称强化治疗组,30例)和常规治疗组(30例),强化治疗组患者在标准治疗基础上每日服用瑞舒伐他汀10mg,常规治疗组患者在标准治疗基础上每日服用瑞舒伐他汀5mg。入院后4 h至10 d行冠状动脉支架植入治疗。比较两组病人PCI治疗前、治疗后24 h、4周、8周和12周血清LDL-C和hs-CRP水平,观察病人血清转氨酶和肌酸激酶(CK)变化。结果:(1)两组PCI术前及PCI术后24 h、8周、12周LDL-C水平均无显著性差异(P均>0.05),PCI术后4周强化治疗组LDL-C水平明显低于常规治疗组[(2.92±0.47)mmol/L比(3.65±0.39)mmol/L,P<0.05];(2)两组术前及术后8周、12周血清hs-CRP水平无显著性差异(P均>0.05),两组PCI术后24h hs-CRP均明显高于术前[强化治疗组(17.38±2.98)mg/L比(14.21±2.50 mg/L),常规治疗组(17.12±2.02)mg/L比(13.30±1.97)mg/L,P<0.01],强化治疗组术后4周hs-CRP水平明显低于常规治疗组[(7.22±0.89)mg/L比(10.12±1.43)mg/L,P<0.01];(3)在4周心脏肌钙蛋白I(cTnI)水平升高:常规治疗组4例(14.8%),强化治疗组1例(3.6%)。结论:瑞舒伐他汀强化治疗能够更早降低急性冠脉综合征病人PCI术后炎症反应和血清低密度脂蛋白胆固醇水平,有助于减少患者PCI术后心血管事件发生率。12周可以作为急性冠脉综合征病人接受PCI后瑞舒伐他汀强化治疗与常规治疗的剂量转换时间窗。Objective：To evaluate the effect of rosuvastatin intensive therapy on serum levels of high-sensitivity C-reactive protein（hs-CRP） and low-density lipoprotein-cholesterol（LDL-C） in patients with acute coronary syndrome（ACS） after percutaneous coronary intervention（PCI）.Methods：A total of 60 ACS patients were randomly divided into two groups,rosuvastatin intensive therapy group（intensive therapy group,n=30） and conventional therapy group（n=30）.Based on standard treatment,patients in intensive therapy group were given rosuvastatin 10mg/d oral and in conventional therapy group were given rosuvastatin 5mg/d oral.The serum levels of hs-CRP and LDL-C of the two groups were compared and analyzed before PCI,and 24 h,four weeks,eight weeks,12 weeks after PCI.Results：（1）There was no significant differences between the two groups in LDL-C level before PCI,24h,eight weeks and 12 weeks after PCI（P〉0.05 all）.On four weeks,LDL-C level of intensive therapy group was significantly lower than that of conventional therapy group [（2.92±0.47）mmol/L vs.（3.65±0.39） mmol/L,P〈0.05].（2）No significant differences existed between the two groups in serum hs-CRP level before PCI,eight weeks and 12 weeks after PCI（P〉0.05 all）.At 24h after PCI,serum levels of hs-CRP in both groups were significantly higher than those before PCI [intensive therapy group：（17.38±2.98）mg/L vs.（14.21±2.50）mg/L,conventional therapy group（17.12±2.02） mg/L vs.（13.30±1.97） mg/L,P〈0.01 both].On four weeks after PCI,hs-CRP level of intensive therapy group was significantly lower than that of conventional therapy group [（7.22±0.89） mg/L vs.（10.12±1.43） mg/L,P〈0.01].（3）Cardiac troponin Ⅰ（cTnI） level increase in four weeks：there was four cases（14.8%） for conventional therapy group and one case（3.6%） for intensive therapy group.Conclusion：Rosuvastatin intensive therapy can earlier relieve inflammation and lower serum LDL-C level in ACS patients after PCI.And

关 键 词：瑞舒伐他汀 冠状动脉疾病 炎症 

分 类 号：R541.4[医药卫生—心血管疾病]