辛伐他汀对不稳定性心绞痛患者凝血/纤溶系统的影响及其机制

Effect of Simvastatin on Atherosclerotic Plaque Stabilization in Patients of Unstable Angina

【目的】观察较大剂量辛伐他汀治疗不稳定性心绞痛患者一周后凝血纤溶指标及血清高敏C反应蛋白(hs-CRP)的变化,以了解短期辛伐他汀治疗对斑块稳定和免疫炎症抑制的影响。【方法】84例不稳定性心绞痛患者随机分为常规组(不服用任何调脂药物,42例)和辛伐他汀组(40 mg/d,42例),另有40例非心血管疾病患者为对照组,测定治疗前后凝血纤溶指标、hs-CRP和血脂水平的变化。【结果】不稳定性心绞痛两组治疗前后血脂各组成分的变化差异均无显著性,而辛伐他汀组治疗后血浆FVIIc、FG和PAI较治疗前明显下降,tPA有所升高,而hs-CRP水平明显降低,且血清hs-CRP水平下降与LDL-C及HDL-C水平变化均无相关性。【结论】在不稳定性心绞痛患者早期予以辛伐他汀治疗,可明显影响血浆炎症因子及凝血纤溶因子的水平、可能有利于动脉粥样硬化斑块的稳定。

[Objective]To observe the influence of simvastatin on serum high sensitive C-reactive protein （hs-CRP） levels,coagulative and fibrinolytic parameters in patients of unstable angina（UA）. [Methods]Eighty four patients of unstable angina subjects were divided into 2 groups and 40 control subjects：simvastatin group （40 mg/d, for a week, n = 42）, routine group （no lipid-lowering drugs, n = 42） and 40 noncardiovascular patients for control. Serum hs-CRP level,coagulative and fibrinolytic parameters before and after treatment were detected. [Results]Levels of plasma lipid were not changed before and after treatment in both UA groups. The plasma FVIIc,FG,PAI and hs-CRP were significantly decreased by simvastatin, respectively. There were no relations between the changes of lipid and hs-CRP. [Conclusion]Simvastatin decreases plasma level of inflammatory and coagulative factors in the patients of unstable angina after the one week treatment and it may benefit to atherosclerotic plaque stabilization.