辛伐他汀和普伐他汀对急性冠状动脉综合征患者血脂及C反应蛋白的影响

The Effect of Simvastatin and Pravastatin on Serum Lipid and C Reactive Protein in Patients with Acute Coronary Syndrome

目的观察辛伐他汀一日40 mg 强化降脂治疗与普伐他汀一日20 mg 常规治疗对急性冠状动脉综合征(ACS)患者血脂及 C 反应蛋白(CRP)水平的影响。方法选择我院2006年1月-2007年6月 ACS 住院患者96例,随机分为普伐他汀组(n=46)和辛伐他汀组(n=50),晚间一日1次口服普伐他汀20 mg 或辛伐他汀40 mg,疗程4周,测定患者治疗前及治疗后血脂及 CRP 水平,同时观察药物不良反应。结果治疗前两组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)及 CRP 水平分别为(5.02±0.85)mmol/L、(1.74±1.52)mmol/L、(2.63±0.36)mmol/L、(1.19±0.05)mmol/L、(12.49±9.02)mg/L 和(4.90±1.25)mmol/L、(1.64±1.29)mmol/L、(2.62±0.47)mmol/L、(0.95±0.05)mmol/L、(12.67±17.97)mg/L,组间相比无显著差异(P>0.05)。治疗后两组上述指标分别为(4.50±0.89)mmol/L、(1.55±0.28)mmol/L、(2.36±0.39)mmol/L、(1.12±0.06)mmol/L、(3.11±9.33)mg/L 和(4.11±0.50)mmol/L、(1.45±0.22)mmol/L、(2.04±0.24)mmol/L、(0.94±0.09)mmol/L、(1.70±1.42)mg/L,其中 TC、LDL-C 和 CRP 水平均较治疗前显著下降,且辛伐他汀组与普伐他汀组相比,前者 TC、LDL-C 和 CRP 水平下降更为显著(P<0.05)。两组患者均未出现非可逆性严重不良反应。结论与普伐他汀一日20 mg 相比,辛伐他汀一日40 mg 强化降脂治疗不仅能显著降低 TC 和 LDL-C,而且能显著降低 CRP,从而使 ACS 患者获益更多。

Objective To evaluate the effect of simvastatin and pravastatin on serum lipid and c reactive protein （ CRP ） in patients with acute coronary syndrome （ ACS ）. Methods 96 patients with ACS were randomly divided into two groups, Pravastatin group （ n=46 ） and simvastatin group （ n=50 ）. Patients were administered pravastatin 20 mg or simvastatin 40 mg once daily respectively. The level of serum lipid and CRP were measured before and after 4 weeks of treatment. Adverse effects were observed in both groups. Results The level of serum lipid and CRP had no differences between two groups before treatment （ P 〉 0.05 ）. After 4 weeks of treatment, the level of total cholesterol （ TC ） , low density lipoprorein cholesterol （ LDL-C ） and CRP reduced significantly in both groups and the level of TC, LDL-C and CRP in simvastatin group were lower than that in pravastatin group （ P 〈 0.05 ）. There were no differences between two groups in adverse effects. Conclusion Compared with pravastatin 20mg once daily, sivastatin 40mg once daily can reduce the level of TC and LDL-C lower. Furthermore, it can reduce the level of CRP much lower. Simvastatin 40rag once daily can be more beneficial for the patients with ACS.