不同剂量阿托伐他汀对急性冠脉综合征患者高敏C反应蛋白的影响

Effects of atorvastatin with different doses on hs-CRP level in patients with acute coronary syndrome

目的:探讨不同剂量阿托伐他汀干预治疗对急性冠脉综合征(ACS)患者血脂及血清高敏C反应蛋白(hs-CRP)的影响。方法:128例ACS患者被随机分为阿托伐他汀大剂量组(40mg/d,64例)和阿托伐他汀常规剂量组(20mg/d,64例),分别在入院24 h内及服药后3、7 d测定两组患者血脂、hs-CRP水平,并进行比较。结果:(1)治疗7 d后,阿托伐他汀两组总胆固醇(TC)[常规剂量组(4.4±0.9)mmol/L∶(5.6±1.2)mmol/L,大剂量组(4.2±0.9)mmol/L∶(5.7±1.2)mmol/L]、低密度脂蛋白-胆固醇(LDL-C)[常规剂量组(2.1±0.6)mmol/L∶(3.3±0.7)mmol/L,大剂量组(2.3±0.7)mmol/L∶(3.4±0.8)mmol/L]均较治疗前明显下降(P均<0.05),但治疗前、后两组TC和LDL-C水平均无显著差异(P>0.05);(2)治疗后7d,阿托伐他汀大剂量组hs-CRP水平较治疗前显著降低[(5.0±1.9)mg/L∶(17.5±6.4)mg/L],且较常规剂量组[(7.1±4.8)mg/L]下降更显著(P均<0.01)。结论:大剂量阿托伐他汀较常规剂量更能降低急性冠脉综合征患者的高敏C反应蛋白水平。

Objective：To investigate effects of atorvastatin with different doses on levels of blood lipid and serum high sensitive C-reactive protein（hs-CRP） in patients with acute coronary syndrome（ACS）.Methods：A total of 128 ACS patients were randomly divided into large dosage of atorvastatin group（40mg/d,n=64） and routine dosage of atorvastatin group（20mg/d,n=64）.Serum levels of blood lipid,hs-CRP of the two groups were measured with biochemistry assay within 24h after admission,3d and 7d after therapy.The difference in blood lipid and hs-CRP levels was compared between the two groups.Results：（1）After 7d,levels of total cholesterol（TC）[routine dosage group：（4.4±0.9） mmol/L vs.（5.6±1.2） mmol/L,large dosage group：（4.2±0.9） mmol/L vs.（5.7±1.2） mmol/L]and low density lipoprotein-cholesterol（LDL-C） [routine dosage group：（2.1±0.6） mmol/L vs.（3.3±0.7） mmol/L,large dosage group：（2.3±0.7） mmol/L vs.（3.4±0.8） mmol/L]significantly decreased compared with before treatment（P0.05 all）,but there was no significant difference between the two groups for above indexes before and after treatment（P0.05）;（2）After 7d,hs-CRP level of large dosage group significantly decreased compared with before treatment [（5.0±1.9）mg/L vs.（17.5±6.4）mg/L],and it was more than that of routine dosage group [（7.1±4.8） mg/L,P0.01 all].Conclusion：Application of large dosage of atorvastatin could better decrease hs-CRP level in patients with acute coronary syndromes.