高脂血症患者短期停用阿托伐他汀治疗后C反应蛋白的变化及临床意义

CLINICAL SIGNIFICANCE AND CHANGES OF INFLAMMATORY MARKERS C-REACTIVE PROTEIN(CRP)IN PATIENTS WITH HYPERLIPIDEMIA AFTER WITHDRAWAL OF ATORVASTATIN TREATMENT IN SHORT TERM

[目的]探讨短期停用阿托伐他汀对高脂血症患者C反应蛋白浓度的影响及临床意义。[方法]30例血脂紊乱患者(男20例,女10例)服用阿托伐他汀(10mg/d)12周。接受阿托伐他汀治疗前、后以及停用后3d分别检查患者血脂水平。并且在接受阿托伐他汀治疗前、后以及停用后1,3d分别检查患者血浆高敏C反应蛋白浓度。[结果]阿托伐他汀12周治疗能明显降低总胆固醇(TC:6.89±0.26vs.5.27±0.13mmol/L,P﹤0.01)、低密度脂蛋白胆固醇(LDL:4.30±0.12vs.3.04±0.09mmol/L,P﹤0.01)和甘油三酯,并且使高密度脂蛋白胆固醇升高,血浆高敏C反应蛋白浓度降低(中位数:1.47vs.1.03mg/L,P﹤0.01)。停用后3d血脂水平无明显变化,但血浆高敏C反应蛋白浓度较治疗后明显升高(中位数:1.03vs.1.40mg/LP﹤0.01)。[结论]阿托伐他汀12周治疗能明显改善血脂紊乱降低血浆高敏C反应蛋白浓度,但短期停用可能导致C反应蛋白浓度反弹升高。

[Objective] To explore the influence on the inflammatory markers C-reactive protein（CRP）in patients with hyperlipidemia after withdrawal of atorvastatin treatment in short term and its clinical significance.Methods Thirty patients including 20 men and 10 women with hyperlipidemia were treated with 10 mg/day of atorvastatin for 12 weeks.Except for the detection of the concentration of plasma CRP at the time of one day,the concentration of blood fat and plasma CRP were evaluated before and after atorvastatin therapy and at the time of the third day of withdrawal of atorvastation treatment.Results Atorvastatin therapy could significantly reduce the value of total cholesterol（TC：6.89±0.26 vs.5.27±0.13 mmol/L,P﹤0.01）,low-density lipoprotein cholesterol（LDL：4.30±0.12 vs.3.04±0.09mmol/L,P﹤0.01）,triglycerides and CRP（median：1.47vs.1.03 mg/L,P﹤0.05）,and could increase the high density lipoprotein cholesterol.After withdrawal of atorvastatin treatment for 3 days,the level of blood fat did not show obviously changes,but the concentration of CRP in blood plasma was found significantly increased（median：1.03 vs.1.40 mg/L P﹤0.05）.Conclusion Treatment with atorvastatin for 12 weeks could obviously improve the disorder of blood fact and decrease the concentration of CRP in blood plasma,but short-term withdrawal of treatment could induce the increasing of CRP concentration.