阿托伐他汀对急性冠脉综合征患者脂联素和超敏C反应蛋白的影响

Effect of Atorvastatin on Serum hs-CRP and Adiponectin in Patients with Acute Coronary Syndrome

目的探讨阿托伐他汀干预对急性冠脉综合征(ACS)患者血清脂联素(APN)和超敏C反应蛋白(hs-CRP)的影响。方法采用酶联免疫吸附法(ELISA法)测定85例ACS患者和40例健康对照组的血清脂联素和hs-CRP水平;将ACS患者随机分为阿托伐他汀治疗组45例,在常规治疗基础上每晚口服阿托伐他汀40mg/d,ACS对照组40例仅常规治疗。于治疗前后分别测定血清脂联素和hs-CRP水平,并进行比较和相关分析。结果与健康对照组比,ACS患者血清脂联素水平显著降低,而血清hs-CRP水平显著升高,差异有统计学意义(P<0.01)。治疗后8周与治疗前比较,阿托伐他汀治疗组和ACS对照组的血清脂联素水平均显著升高,hs-CRP水平均显著下降;与ACS对照组比较,阿托伐他汀治疗组治疗后血清脂联素水平更高,而血清hs-CRP水平更低,差异有统计学意义(P<0.01)。ACS患者的血清脂联素与hs-CRP呈负相关(r=-0.348,P=0.013)。结论ACS患者血清脂联素下降和hs-CRP升高在粥样斑块的炎症反应起重要作用。阿托伐他汀等他汀类药物可通过降低血清hs-CRP及升高脂联素等促炎性细胞因子的水平,减轻ACS患者粥样斑块内的炎症。

Objective To discuss the effect of atorvastatin intervention on serum hs-CRP and adiponeetin in patients with acute coronary syndrome （ACS）. Methods The levels of serum hs-CRP and APN were determined by ELISA method in 85 cases of ACS patients and 40 eases of healthy controls. At the same time,ACS patients were randomly divided into atorvastatin group （atorvastatin 40 mg/qu,n = 45） and control group. Before and after atorvastatin treatment, the levels of serum hs-CRP and APN were measured,which were treated with group comparison and correlation analysis. Results Compared with the control group,the sertma APN level was statistically decreased,and the serum hs-CRP level was statistically increased in ACS patients （all P 〈0. 01 ）. In atorvastatin group and control group,the serum APN level significantly increased and the serum hs-CRP level significantly decreased after 8 weeks treatment. Compared with the control group,the serum APN levels were higher, and the serum hs-CRP level was lower in the atorvastatin group,the difference was statistically significant （all P 〈0.01 ）. ACS patients with the serum APN level was negatively correlated to the serum hs-CRP level in ACS group （r = -0.348,P =0.013）. Conclusion Decrease of serum APN level and increase of hs-CRP level in ACS patients plays an important role on the inflammatory response in the atherosclerotic plaque. Statin drugs such as atorvastatin can modulate proinflammatory cytokine levels,such as reducing sermn hs-CRP level and increasing APN level,and then reduce inflammation within the plaque in patients with ACS.