辛伐他汀对冠心病患者血浆纤溶活性的改善作用

The improvement effect of simvastatin on the plasma fibrinolysis activities in patients with coronary heart disease (CHD)

目的研究辛伐他汀、抵克立得、阿司匹林对冠心病(CHD)患者血浆PAI-1含量的影响。方法选取2003-03-2003-10在长海医院冠状动脉造影诊断为CHD 65例(男34例,女31例,年龄50-75 岁),分为2组。A组33例术后均给予口服抵克立得250mg 2次／d,阿斯匹林300mg 1次／d。辛伐他汀 20mg每晚临睡前;B组32例口服抵克立得250mg 2次／d,阿斯匹林300mg 1次／d,治疗前及治疗后1 个月抽取血标本检测PAI-1、t-PA、CRP。结果与治疗前相比,A组PAI-1[(37．69±17)vs(26．79±13．34) ng／ml,P<0．01]、t-PA[(12．92±10．53)vs(8．72±6．98)ng／ml,P<0．05]、CRP[(13．90±20．03)vs(6．50±5．60) mg／L,P<0．05]明显降低。B组PAI-1[(37．65±17．18)vs(33．42±12．30)ng／ml,P<0．05]、CRP[(13．98±13．22) vs(10．25±6．08)mg／L,P<0．05]也明显降低,t-PA有下降趋势,但无显著性差异。A、B两组治疗后比较,A 组CRP[A组(6．50±5．60)vs B组(10．25±6．08)mg／L,P<0．05]、PAl-1[A组(26．79±13．34)vs B组(33．42± 12．30)ng／ml,P<0．05]含量较B组下降明显。结论抗血小板药物的长期治疗能够提高患者血浆纤溶活性,联合应用辛伐他汀治疗比单独应用抗血小板药物效果更好。

Objective To investigate the effect of simvastatin,ticlopidin and aspirin on the plasma plasminogen activitor inhibitor-1（PAI-1） contents in CHD patients.Method Seventy-two CHD patients（m 34,f 31,50-75 years old） who were diagnosed by coronary angiography in Changhal hospital from March. 2003 to Oct. 2003 were divided into 2 group：A and B.The group A （33 patients） was given ticlopidin 250mg bid, aspirin 300mg qd,simvastatin 20mg qn,and the group B included 32 patients was given ticlopidin 250mg bid,aspirin 300mg qd for four weeks, The plasma PAI-1,t-PA and CRP were measured before and after the treatment.Results The plasma content of PAI-1（37.69±17 vs 26.79±13.34ng/nd,P〈 0.01）, t-PA （12.92±10.53 vs 8.72±6.98ng/ml,P〈0.05）, and CRP（13.90±20.03 vs 6.50±5.60mg/L,P〈 0.05） were decreased significantly in group A. The plasma content of PAI-1 （37.65±17.18 vs 33.42±12.30ng/ml,P〈0.05）, and CRP （13.98±13.22 vs 10.25±6.08mg/L,P〈0.05） were also decreased in group B.The content of CRP（A：6.50±5.60 vs B：10.25±6.08mg/L,P〈0.05）and PAI-1（A：26.79±13.34 vs B：33.42±12.30ng/ml,P〈0.05）decreased more significantly in group A than that in group B.Conclusion Antiplatlete therapy can improve the fibrinolitic activity through long term treatment. The combination therapies of simvastatin and antiplatlete drugs have more significant effects than antiplatlete therapy alone.