瑞舒伐他汀与不同剂量阿托伐他汀对急性冠状动脉综合征患者炎症因子的影响

Effects of rosuvastatin and atorvastatin on inflammatory factors in patients with acute coronary syndrome

目的 探讨10mg、20mg的阿托伐他汀和10mg瑞舒伐他汀对急性冠状动脉综合征（ACS）患者炎症因子的影响。方法66例ACS患者随机分为3组：10mg阿托伐他汀治疗组、20mg阿托伐他汀治疗组和10mg瑞舒伐他汀治疗组，各22例。分别检测治疗前和治疗2周后血清基质金属蛋白酶-9（MMP-9）和纤溶酶原激活剂抑制因子-1（PAI-1）的水平以及与血脂变化的相关性。井选同期冠状动脉造影正常者19倒作为正常对照组。结果ACS患者血脂（除TG外）、血清中MMP-9和PAI-1的浓度与正常对照组比较差异均有统计学意义（P〈0．05或P〈0．01），经阿托伐他汀和瑞舒伐他汀治疗后3组各检测指标除甘油TG外与治疗前比较差异均有统计学意义（P均〈0．01）；以阿托伐他汀20mg和瑞舒伐他汀10mg治疗组变化幅度最大（P〈0．05或P〈0．01）。阿托伐他汀和瑞舒伐他汀降低血清MMP-9和PAI—1的浓度与血脂变化无相关性（P均〉0．05）。结论瑞舒伐他汀10mg具有独立于降脂作用之外的抗炎效应，较阿托伐他汀10mg更能显著降低ACS患者血清MMP-9和PAI-1的水平，效果等同于阿托伐他汀20mg。

Objective To investigate the effeets of 10 mg and 20mg atorvastatin and 10 mg rosuvastatin on inflammatory factors in patients with acute coronary syndrome （ACS）. Methods 66 patients with ACS were randomly divided into three groups： the 10 mg atorvastatin group, the 20 mg atorvastatin group and the 10 mg rosuvastatin group（n = 22 for each group）. The levels of blood lipids, serum matrix metalloproteinases-9 （MMP-9） and plasminogen activator inhibitor-1 （ PAI-1 ） were measured before and after two-week treatment. 19 patients with normal coronary angiography were assigned to the control group. Results The concentration of serum MMP-9 and PAI-1 was higher significantly in patients with ACS than those in control subjects（ P 〈 0.05 or P 〈 0.01 ）. After two weeks＇ treatment,the serum MMP-9 and PAI-1 levels were lowered significantly（P 〈 0.01 ）, which were much better in groups of 20rag atorvastatin and of 10mg rosuvastatin than those in group of 10mg atorvastatin （ P 〈 0.05 or P 〈 0.01 ） . No relationship was observed between the levels of above inflammatory markers and serum lipids levels （P 〉0.05）. Conclusion 10 mg Rosuvastatin can greatly reduce the serum level of MMP-9 and PAI-1 as compared to 10 mg atorvastatin in patients with ACS , equivalent to the effect of 20 mg atorvastatin, suggesting that the anti-inflammatory effect is independent of lipid-lowering action.