不同剂量阿托伐他汀在不稳定型心绞痛患者的早期应用

Early treatment with different doses of atorvastatin in patients with unstable angina pectoris

目的:观察不稳定型心绞痛(UAP)患者使用2种剂量(10和20mg/d)的阿托伐他汀治疗10d后血脂、高敏C反应蛋白(hsCRP)、基质金属蛋白酶9(MMP9)、一氧化氮(NO)、肌酸激酶(CK)及谷丙转氨酶(ALT)的变化。方法:将临床确诊为UAP的90例患者随机分为:阿托伐他汀治疗组:分别接受10mg/d(32例)和20mg/d(30例)阿托伐他汀治疗;对照组(28例):不接受任何调脂药物治疗;所有对象均测定治疗前和治疗10d后hsCRP、MMP9、NO、ALT、CK和血脂水平的变化。结果:阿托伐他汀治疗组治疗前后比较,血脂、hsCRP、MMP9水平明显下降(P<0.05),与对照组治疗后相比亦明显下降(P<0.05);除hsCRP外,20mg/d较10mg/d治疗后血脂、MMP9水平下降更显著(P<0.05)。20mg/d治疗前后比较,ALT水平显著升高(P<0.05);治疗后2组ALT水平依次升高,且差异有统计学意义(P<0.05)。结论:在UAP早期使用较大剂量(20mg/d)的阿托伐他汀治疗10d,即可明显减轻炎症、调节血脂、稳定斑块。

Objective： To observe the effects of the treatment with two different doses of atorvastatin （10mg · d^-1, 20 mg · d^-1） for 10 days on blood high sensitivity C-reactive protein （hsCRP）, matrix metalloproteinase-9 （MMP-9）, nitricoxide（NO）, creatine kinase （CK）, atanine transaminase （ALT）, and lipid in patients with unstable angina pectoris （UAP） . Method： Ninety patients with UAP were randomly assigned into three groups：control group （ n =28） treated with none of lipid-lowering drugs, 10 mg（ n =32） and 20 mg （ n =30） atorvastatin groups administrated Atorvastatin 10 mg · d^-1 ang 20 mg· d^-1 respectively for 10 days . Blood levels of hsCRP, MMP-9, NO, ALT, CK,and lipid were all detected before and after the treatment. Result：On the 10th day of the treatment, the levels of hsCRP, MMP-9 and lipid were all reduced while those of ALT elevated markedly in 10 mg and 20 mg atorvastatin groups compared with those before the treatment and the controls （ P 〈0.05） , especially MMP-9, lipid and ALT in 20 mg atorvastatin group. Conclusion： Early treatment with high dose of Atorvastatin for 10 days in patients with unstable angina pectoris could reduce inflammation, lower blood lipid and improve atherosclerotic plaque stability.