辛伐他汀对低低密度脂蛋白胆固醇并高高敏C反应蛋白的急性冠脉综合征患者的干预作用

Interventional Effect of Simvastatin on Acute Coronary Syndrome Patients With Low Level of Low-Density Lipoprotein Cholesterol and High Level of High Sensitivity C-Reactive Protein

目的:探讨辛伐他汀对低低密度脂蛋白胆固醇(LDL-C)并高高敏C反应蛋白(hsCRP)的急性冠脉综合征(ACS)患者的干预作用。方法:将131例低LDL-C同时伴有高hsCRP的患者随机分为治疗组68例(常规治疗+辛伐他汀20mg,1次/晚)和对照组63例(常规治疗),观察12周调脂治疗对心脏事件(包括再发心绞痛、再发心肌梗死、心功能恶化、猝死)的影响,及血浆LDL-C及hsCRP的变化。结果:治疗组经辛伐他汀治疗后LDL-C由(3.04±0.76)mmol/L降至(1.58±0.43)mmol/L,较治疗前明显下降,差异有统计学意义(P<0.05),hsCRP由(5.29±3.67)mmol/L降至(1.62±0.54)mmol/L,较治疗前明显下降,差异有统计学意义(P<0.05),对照组常规治疗后hsCRP由(5.83±4.14)mmol/L降至(3.18±1.62)mmol/L,治疗前后比较差异有统计学意义(P<0.05),治疗组治疗后与对照组治疗后比较LDL-C及hsCRP均下降,差异有统计学意义(P<0.05),治疗组心脏事件的发生较对照组明显减少,差异有显著统计学意义(P<0.001)。结论:急性冠脉综合征患者在常规处理基础上加用辛伐他汀治疗可显著降低LDL-C及hsCRP水平,同时减少了心脏事件再发。

Objective ： To evaluate the effect of Simvastatin on acute coronary syndrom（ACS） patients with low level of lowdensity lipoprotein cholesterol （LDL-C） and high level of high sensitivity C-reactive protein （hsCRP）. Methods： A total of 131 ACS patients with low level of plasma LDL-C and high level of plasma hsCRP were divided into two groups ： treatment group （ conventional medication plus Simvastatin 20 mg q. n. , n = 68 ） and control group （ conventional medication,n = 63 ）. Cardiac events （including recurrent angina, recurrent myocardial infarction, worsen of cardiac function and sudden death） and the changes of plasma LDL-C and hsCRP were followed up for 12 weeks. Results： Compared with the control group, plasma LDL-C and hsCRP decreased significantly in the treatment group： LDL-C from 3.04 ± 0. 76 mmol/L to 1.58 ±0. 43 mmol/L （P 〈0. 05） after treatment;hsCRP from 5.29 ±3. 67 mmol/L to 1.62±0. 54 mnlot/L（P 〈 0. 05 ） after treatment. In control group with conventional medication, hsCRP from 5.83 ± 4. 14 mmol/L to 3.18± 1.62 mmol/L, （P 〈 0. 05 ） after treatment. All those changes had the statistic meaning. The occurrence of cardiac events in the treatment group was significantly lower than that in the control group （ P 〈 0. 001 ）. Conclusion ： Sinvastatin plus the conventional medication could significantly decrease the plasma levels of LDL-C and hsCRP in ACS patients, and at the same time,it could reduce the recurrence of the cardiac events in ACS patients as well.