大剂量辛伐他汀对急性冠状动脉综合征患者血小板CD40L表达的影响  

Influence of high-dose simvastatin on platelet CD40 ligand expression in patients with acute coronary syndrome

作　　者：楚罗湘[1] 赖沙毅[1] 谢剑[1] 

机构地区：[1]广西医科大学第四附属医院心内科,柳州市545005

出　　处：《中华实用诊断与治疗杂志》2013年第2期121-123,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：广西柳州市科学研究与技术开发计划项目(2008031415)

摘　　要：目的观察早期应用大剂量辛伐他汀强化治疗对急性冠状动脉综合征患者血小板CD40L表达的影响。方法 87例急性冠状动脉综合征患者随机分为小剂量辛伐他汀组46例和大剂量辛伐他汀组41例,患者在标准化治疗基础上于入院24h内给予辛伐他汀治疗,小剂量辛伐他汀组给予辛伐他汀20mg/d,大剂量辛伐他汀组给予辛伐他汀60mg/d,均口服7d。观察2组治疗前、后血小板聚集率、血小板CD40L表达的变化。结果治疗后2组血小板聚集率较治疗前均明显下降(P<0.05),大剂量辛伐他汀组血小板聚集率((29.4±7.7)%)较小剂量辛伐他丁组((34.2±11.1)%)降低更明显(P<0.05);治疗后2组血小板CD40L水平均明显下降(P<0.05),大剂量辛伐他汀组血小板CD40L水平(3.07±0.86)较小剂量辛伐他汀组(3.41±0.70)下降更明显(P<0.05)。结论早期大剂量辛伐他汀短期治疗可有效抑制血小板功能,降低血小板CD40L的表达。Objective To observe the influence of the early use of high-dose simvastatin on platelet CD40 ligand expression in patients with acute coronary syndrome. Methods Eighty-seven cases of acute coronary syndrome were randomly divided into low dose simvastatin group （n= 46） and high-dose simvastatin group （n= 41）. The low-dose simvastatin group was given simvastatin 20 rag/d, and the high-close simvastatin group was given simvastatin 60 mg/d in 24 hours after admission for totally 7 days based on conventional drug therapy. The platelet aggregation rate and platelet CD40 ligand expression were detected before and after treatment. Results After one week, platelet aggregation rate decreased significantly in both groups （P ~ 0.05）, and decreased more significantly in high dose simvastatin group （（29.4 ± 7.7）% ） than that in low-dose simvastatin group （（34.2± 11.1%） （P〈0.05）. The platelet CD40 ligand level decreased significantly in two groups after treatment, and decreased more significantly in high-dose simvastatin group （3.07±0.86） than that in low dose simvastatin group （3.41±0.70） （P〈0.05）. Conclusion The early use of high- dose simvastatin can effectively reduce platelet aggregation rate and platelet CD40 ligand expression in short term in patients with acute coronary syndrome.

关 键 词：急性冠状动脉综合征 辛伐他汀 血小板 CD40L 

分 类 号：R541.4[医药卫生—心血管疾病]