瑞苏伐他汀和阿托伐他汀治疗对冠心病患者妊娠相关血清蛋白A的影响

Effect of rosuvastatin and atorvastatin therapy on pregnancy-associated plasma protein-A in patients with coronary heart disease

目的观察瑞苏伐他汀和阿托伐他汀治疗对冠心病患者妊娠相关血清蛋白A(PAPP-A)和血清高敏C反应蛋白(hs-CRP)的表达变化。方法选择临床确诊的冠心病患者117例,其中非ST段抬高心肌梗死和不稳定性心绞痛患者46例统称为急性冠状动脉综合征(ACS),稳定性心绞痛71例,随机分为瑞苏伐他汀组(60例)和阿托伐他汀组(57例)。分别测量治疗前以及治疗30天和6个月血清中PAPP-A、hs-CRP和血脂的变化情况。结果与稳定性心绞痛患者比较,ACS患者PAPP-A和hs-CRP明显升高(P<0.05)。瑞苏伐他汀组患者PAPP-A水平在治疗30天及6个月较治疗前明显下降,差异有统计学意义(P<0.05);阿托伐他汀组患者在治疗30天PAPP-A水平没有明显变化,6个月时则明显下降(P<0.05);两组患者hs-CRP水平在治疗30天较治疗前没有明显变化,但治疗6个月时则明显下降(P<0.05)。PAPP-A与hs-CRP的表达没有相关性。结论 PAPP-A和hs-CRP水平在ACS患者中明显升高,瑞苏伐他汀和阿托伐他汀均能够降低冠心病患者血清中PAPP-A和hs-CRP水平。

Objective To observe the effect of rosuvastatin and atorvastatin therapy on pregnancy- associated plasma protein-A（PAPP-A） in the patients with coronary heart disease（CHD）. Methods 112 patients with CHD verified by invasive coronary angiography were selected. Of them,46 had acute coronary syndrome（ACS,including non-ST-elevation myocardial infarction and unstable angina） and 71 had stable angina. They were randomly assigned to rosuvastatin（60 patients） and atorvastatin（57 patients） groups. PAPP-A, hs-CRP and lipids were measured before and after 1 and 6 months therapy. Results PAPP-A and hs-CRP were significantly increased in 46 patients with ACS compared with 71 patients with stable CHD （P 〈 0.05）. After 1 and 6 months therapy with rosuvastatin the level of PAPP-A was significantly decreased compared with baseline. Al- though the level of PAPP-A in atorvastatin group did not show difference at 1 month,it was significantly decreased at 6 months. Although the level of hs-CRP in both rosuvastatin and atorvasta- tin groups did not show difference at 1 month compared with baseline, it was significantly decreased at 6 months （P 〈 0.05）. There was no significant correlation between PAPP-A and hs- CRP. Conclusion Levels of PAPP-A and hs-CRP were significantly increased in patients with ACS compared with stable CAD, whereas they were significantly decreased in patients treated with rosuvastatin and atorvastatin.