不同剂量辛伐他汀对不稳定型心绞痛患者血脂及血清淀粉样蛋白A的影响

Influence of two different doses of simvastatin on levels of serum amyloid A and serum lipid in the patients with UAP

目的观察不同剂量辛伐他汀早期干预对不稳定型心绞痛(UAP)患者血清淀粉样蛋白A(SAA)水平的影响及调脂作用与安全性。方法选择入院具有缺血性胸痛、冠状动脉造影异常临床诊断UAP患者41例,随机分组:①常规治疗加辛伐他汀20mg治疗组20例;②常规治疗加辛伐他汀40mg治疗组21例。另选18名健康体检者为对照组。分别测定UAP患者治疗前、辛伐他汀20mg和40mg治疗2周后及对照组外周血SAA和血脂水平。SAA用ELISA法检测,同时观察用药安全性。结果UAP应用不同剂量辛伐他汀治疗后,40mg组TC、LDL-C的水平较20mg组低[(4.73±0.44)mmol/L和(5.05±0.34)mmol/L,(2.96±0.27)mmol/L和(3.16±0.29)mmol/L,P均<0.05];40mg组血清SAA水平下降更为显著[(1600±257)ng/ml和(2479±365)ng/ml,P<0.O5]。单因素相关分析显示,血清SAA浓度与患者较高的TC、LDL-C、HDL-C和TG的基线值无相关性(r=0.133,P=0.329;r=0.196,P=0.148;r=0.154,P=0.257;r=-0.168,P=0.216,P>0.O5)。结论①UAP患者血清SAA水平明显升高;②应用辛伐他汀治疗可明显降低SAA水平,且与TC、LDL-C降低水平无相关性。SAA降低程度可能与辛伐他汀剂量有关。

Objective To observe the influence of two different doses simvastatin on serum SAA and lipid and security in patients with Unstable angina pectoris （UAP）. Methods 41 consecutive patients with UAP randomized and divided into two groups： groupl（n=20） was given 20 mg/d simvastatin at night, group 2（n=21 ） was given 40 mg/d simvastatin,control group （n=18） was no lipid-lowering drugs.Coronary angiography was performed in all patients with gAP.After 2 weeks of treatment. SAA was determined using enzyme-linked immunosorbent assay（ELISA）kits. Results Levels of lipid levels（TC,LDL-C） were decreased more significantly in the Sim- vastatin 40 mg group than 20 mg group （P〈0.05,respectively）. Comparing with 20 mg/d simvastatin group,there was relatively lower levels of SAA in the 40 mg/d simvastatin group （P〈0.05）. Qne factor correlation analysis showed the level of SAA was not correlated with the baseline concentration level of serum TC and LDL-C （r= 0.133,P：0.329,r=0 196,P=0.148,P〉0.05 respectively）. Conduslon （1）The baseline serum levels of SAA was higher in the UAP group; （2）Simvastatin decreased significantly the level of SAA and it was associated with the dose of simvastatin. No correlation was observed between the level of SAA decreased by using of simvastatin and the level of LDL-C or TC. Patients with UAP may benefit more from the use of higher dose simvastatin.