心血管事件高危患者餐后C反应蛋白质量浓度变化及辛伐他汀干预结果分析

Influence of simvastatin on postprandial C-reactive protein concentrations in patients at high risk of cardiovascular event

目的研究心血管事件高危患者高脂餐后血浆C反应蛋白(CRP)质量浓度的变化,探讨极短期辛伐他汀对血浆CRP质量浓度的影响。方法对肇庆市端州区人民医院于2003-10-2004-0670例冠心痛及其高危症患者随机分为辛伐他汀组(36例)和常规治疗组(34例),分别在常规治疗的基础上加服辛伐他汀(20mg/d)和安慰剂。治疗前和1周后接受高脂餐负荷试验,检测空腹和餐后4h血浆CRP质量浓度和血脂水平。结果两组患者的餐后血浆甘油三酯和CRP质量浓度较空腹水平明显升高(P<0.05)。1周后常规治疗组的空腹和餐后血浆CRP质量浓度和血脂水平无显著变化;辛伐他汀组的餐后血浆甘油三酯和CRP质量浓度较治疗前显著降低,但血浆CRP质量浓度降低与血脂的变化无显著相关。结论极短期辛伐他汀治疗有效降低心血管事件高危患者餐后升高的血浆CRP质量浓度。

Objective To study the changes of postprandial plasma C-reactive protein(CRP)concentrations after a high-fat meal (800 calorie;50g fat) in patients at high risk of cardiovascular event,and explore the influence of simvastatin on CRP concentration in very short time. Methods 70 patients at high risk of cardiovascular disease were randomly divided into two groups to accept either simvastatin (20mg/d) (SIM group, n=36)or placebo (ROU group, n=34) at the base of routine therapy. All patients received an oral high-fat meal at baseline and one week later. The concentrations of plasma triglyceride(TG), total cholesterol, LDL-cholesterol, HDL-cholesterol and CRP in fasting state and at 4 hours postprandially were measured. Results The postprandial plasma TG and CRP concentrations increased significantly ( P <0.05) in all patients. After one week, the fasting or postprandial plasma lipids levels and CRP concentration did not change significantly in ROU group comparing to the baseline, while the postprandial plasma TG and CRP concentrations significantly decreased in SIM group. The reduction of plasma CRP concentration was not significantly related to the changes of plasma lipids levels. Conclusion Simvastatin can effectively reduce postprandial plasma CRP concentrations in patients at high risk of cardiovascular event in very short time.