强化降脂治疗对不稳定型心绞痛患者血清高敏C反应蛋白、可溶性血管细胞黏附分子1水平的影响

Influence of aggressive lipid-lowering treatment on serum high-sensitive C-reactive protein and soluble vascular cell adhesion molecule-1 in patients with unstable angina

目的探讨大剂量氟伐他汀对不稳定型心绞痛患者血清炎症因子高敏C反应蛋白(hsCRP)、可溶性血管细胞黏附分子1(sVCAM-1)水平的影响。方法将不稳定型心绞痛患者70例随机分为两组,每组各35例。A组在常规治疗基础上给予氟伐他汀40mg/d,B组在常规治疗基础上给予氟伐他汀80mg/d,用酶联免疫吸附测定法检测治疗前后血清hsCRP、sVCAM-1水平,并检测其他临床指标。结果治疗2周后,两组总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)均较治疗前降低(P<0.05),但组间比较差异无统计学意义(P>0.05);两组治疗后hsCRP、sVCAM-1浓度均比治疗前降低(P<0.01),治疗后两组比较差异有统计学意义(P<0.01),治疗后A组和B组分别为hsCRP(10.52±1.76)mg/L vs(7.79±1.53)mg/L;sVCAM-1(441.18±87.06)μg/L vs(347.91±94.25)μg/L;hsCRP、sVCAM-1下降与LDL-C、TC下降无相关性(P>0.05)。结论强化降脂治疗能明显抑制不稳定型心绞痛患者的炎症反应,降低血清hsCRP和sVCAM-1水平,氟伐他汀的抗炎作用独立于降脂作用以外。

Objective To study the influence of the high dose fluvastatin on serum inflammation cytokines highsensitive C-reactive protein（hsCRP） and soluble vascular cell adhesion molecule-1（sVCAM-1） concentrations in patients with unstable angina（UA）. Methods Seventy patients with UA were randomly divided into two groups to accept fluvastatin 40 mg daily as group A（n=35）,or fluvastatin 80 mg daily as group B（n=35） at the base of routine therapy.Enzyme-linked immunosorbent assay（ELISA） was used to detect the serum concentrations of hsCRP and sVCAM-1 of all patients before and after therapy,other clinical indexes were also tested. Results The concentrations of TC and LDL-C were decreased after two weeks of treatment in both groups compared to those before treatment（P0.05）,but there were no significant difference after therapy between two groups（P0.05）.The concentrations of hsCRP and sVCAM-1 were significantly decreased after treatment in both groups compared to those before treatment（P0.01）,and there were significant difference after therapy between two groups（P0.01）,hsCRP（10.52±1.76） mg/L vs（7.79±1.53） mg/L in group A than in group B,sVCAM-1（441.18±87.06） μg/L vs（347.91±94.25） μg/L in group A than in group B.The reductions of hsCRP and sVCAM-1 were not related to the changes of TC and LDL-C（P0.05）. Conclusion Aggressive lipid-lowering treatment can inhibit inflammation reaction and decrease the serum concentrations of hsCRP and sVCAM-1 in patients with UA.The anti-inflammation of fluvastatin has no correlation with its lipids suppression.