不同剂量阿托伐他汀对冠心病合并高胆固醇血症患者hs-CRP及sVCAM-1的影响  

Influence of different doses of Atorvastatin on high sensitivity C-reactive protein and soluble vascular cell adhesion molecule1 in patients with coronary atherosclerotic heart disease combined with hyperlipidemia

作　　者：孟辉[1] 王宇平[1] 

机构地区：[1]首都医科大学附属北京潞河医院心内科,北京101149

出　　处：《中华全科医学》2016年第7期1125-1126,1223,共3页Chinese Journal of General Practice

摘　　要：目的分析不同剂量阿托伐他汀对冠心病合并高胆固醇血症患者超敏C反应蛋白(highsensitivity C-reactive protein,hs-CRP)及可溶性血管细胞粘附分子-1(soluble vascular cell adhesion molecule 1,sVCAM-1)的影响。方法选取2012年5月—2014年5月收治的100例冠心病合并高胆固醇血症患者,随机分为A组(阿托伐他汀,40mg/d,50例,其中不稳定心绞痛25例,急性心肌梗死25例)和B组(阿托伐他汀,10 mg/d,50例,其中不稳定心绞痛25例,急性心肌梗死25例)。2组患者均口服阿托伐他汀治疗12周,比较2组第4、12周血清中总胆固醇(total cholesterol,TC)、hs-CRP及sVCAM-1的水平。所有数据应用SPSS 18.0统计学软件进行分析。结果 2组患者治疗前TC、hs-CRP及sVCAM-1差异无统计学意义(P>0.05),心肌梗死患者hs-CRP及sVCAM-1水平显著高于不稳定心绞痛患者(P<0.05);治疗第4、12周2组患者血脂较治疗前明显下降,且A组显著低于B组(P<0.05),第12周下降更为显著(P<0.05);治疗第12周A组患者hs-CRP及sVCAM-1较治疗前显著下降(P<0.05),且第12周较第4周下降显著(P<0.05);各组在治疗过程中均无明显不良反应发生。结论大剂量阿托伐他汀长期治疗冠心病合并高胆固醇血症患者安全有效,降脂的同时降低炎症因子,稳定斑块。Objective To analyze the influence of different doses of Atorvastatin on high sensitivity C-reactive protein and soluble vascular cell adhesion molecule 1 in patients with coronary atheroselerotic heart disease（CHD） combined with hy- perlipidemia. Methods Total 100 cases were selected and randomly divided into 40 mg Atorvastatin calcium group （ A, 50 cases, half unstable angina and half myocardial infarction） and 20 mg Atorvastatin calcium group （ B,50 cases, half un- stable angina and half myocardial infarction）. Before and after 4 weeks and 12 weeks treatment, the serum total cholesterol （TC） ,high-sensitivity C-reactive protein（hs-CRP） and soluble vascular cell adhesion molecule 1 （sVCAM-1） level was tested, and the major adverse drug reaction were recorded. Results No statistical significant difference was found about TC,hs-CRP,sVCAM-1 between group A and group B before Atorvastatin treatment （P 〉 0.05）, there was significant difference about hs-CRP, sVCAM-1 in patients with myocardial infarction compared with unstable angina before Atorvasta- tin treatment（P 〈 0.05 ） ;There was significant difference about TC after 4 weeks and 12 weeks treatment compared with before treatment in each group（P 〈0.05）. And A group had the remarkable significance with B group of TC level（ P 〈 0.05 ） ;There was significant difference about hs-CRP ,sVCAM-1 after 12 weeks treatment compared with before and after 4 weeks treatment in group A（ P 〈 0.05 ）. There was no obvious adverse drug reaction in each group. Conclusion High doses of Atorvastatin is safe and effective in patients with coronary atherosclerotic heart disease combined with hyperlipi- demia,it can significantly decrease blood cholesterol and inflammatory factors levels and may stabilize atherosclerotic plaque. Atorvastatin might play a role in the prevention of CHD.

关 键 词：阿托伐他汀 冠心病 超敏C反应蛋白 可溶性血管细胞粘附分子-1 

分 类 号：R541.4[医药卫生—心血管疾病] R589.2[医药卫生—内科学]