急性冠状动脉综合征的炎症机制及氟伐他汀的抗炎作用

The mechanism of inflammation during acute coronaria syndrome and the anti-inflammation role of fluvastatin

目的:探讨急性冠状动脉综合征(acute coronary syndrome,ACS)的炎症机制及氟伐他汀的抗炎作用。方法:选择稳定型心绞痛(SAP)72例为对照组,ACS84例为治疗组,包括不稳定型心绞痛(UAP)39例,非ST段抬高性心肌梗死(NSTEMI)25例,ST段抬高性心肌梗死(STEMI)20例。治疗组在常规治疗的基础上给予氟伐他汀40mg,晚餐后服用,疗程4周。分别测定治疗前后患者血浆中高敏C反应蛋白(hs-CRP)、胆固醇(CHO)和低密度脂蛋白(LDL-C)水平。结果:治疗前ACS各组hs-CRP水平明显高于SAP组(P<0.01),STEMI组hs-CRP与NSTEMI组和UAP组差异均无统计学意义(P>0.05),ACS各组CHO、LDL-C水平与SAP组差异均无统计学意义(P>0.05),治疗后ACS各组hs-CRP、CHO、LDL-C均明显下降(P<0.01)。结论:炎症反应在ACS的发病中起重要作用,氟伐他汀既有调脂作用,又有抗炎作用。

Objective：To observe the mechanism of inflammation during acute coronaria syndrome （ACS） and the anti-inflammation role of fluvastatin. Methods： Seventy-two cases of stable angina pectoris （SAP） were selected as control, and 84 cases of ACS were enrolled in the treatment group which included 39 cases of unstable angina pectoris （UAP） ,25 cases of non-ST elevated myocardial infarction （NSTEMI） and 20 cases of ST elevated myocardial infarction （STEMI）. The treatment group was prescribed fluvastatin 40 mg in addition to the routine therapy. The fluvastatin was taken after supper and the treatment course lasted for 4 Weeks. The concentrations of high sensitive C reactive protein （hs-CRP）, cholesterol （CHO） and low density lipoprotein （LDL-C） in the blood of the patients were determined before and after treatment separately. Results ： Before treatment, the concentration of hs-CRP in ACS group was obviously higher than that in SAP group（ P 〈 0.01 ） ,while the hs-CRP in STEMI group had no statistic significance compared with that in NSTEMI or UAP groups （ P 〉 0.05） ; the concentrations of CHO and LDL-C in ACS group were not significantly different compared with that in SAP group （P 〉 0.05 ）. After treatment, the concentrations of hs-CRP, CHO and LDL-C in ACS groups were lowered obviously（P 〈 0.01 ）. Conclusions ： Inflammation plays an important role in the process of ACS, and fluvastatin possesses the ability of moderating cholesterol and anti-inflammation.