阿托伐他汀对UA患者血清hs-CRP和Hcy水平变化的影响

Effect of atorvastatin on the levels of serum hypersensitive C-reactive protein and homocysteine for unstable angina

目的探讨阿托伐他汀治疗不稳定型心绞痛(UA)的疗效及其对血清血脂,高敏C反应蛋白(hs-CRP)和同型半胱氨酸(Homocysteine,Hcy)水平的影响。方法选择90例诊断明确的不稳定型心绞痛患者,随机分成两组,对照组给予拜阿司匹林、氢氯吡格雷抗血小板聚集、低分子肝素抗凝治疗;治疗组在常规组基础上予阿托伐他汀40mg,每晚1次,口服。3月后比较两组观察患者用药前后血脂,hs-CRP和Hcy水平变化的变化。结果治疗后两组患者心绞痛症状有明显改善,治疗组有效率为93.33%,优于对照组的75.56%,差异有统计学意义(P<0.05)。治疗前两组血脂,hs-CRP和Hcy水平比较无显著性差异(P>0.05),治疗后两组TC、TG、LDL-C和hs-CRP水均较治疗前明显下降(P<0.01),HDL-C较治疗前明显升高(P<0.01),治疗组较对照组变化更为明显(P<0.01或P<0.05)。对照组在治疗后Hcy水平仅出现下降趋势(P>0.05),但治疗组较治疗前及对照组出现明显下降,差异有统计学意义(P<0.01)。结论阿托伐他汀可提高不稳定型心绞痛的疗效,能降低血中hs-CRP和Hcy水平,从而降低不稳定型心绞痛及动脉粥样硬化危险因素。

Objective To explore the therapeutic effect of atorvastat on the levels of the blood lipid,high-sensitivity C-reactive protein（hs-CRP） and homocysteine（Hcy） in treatment of unstable angina.Methods The 90 patients with confirmed diagnosis of unstable angina（UA） were divided randomly into control group given aspirin,hydrogen clopidogrel,and low molecular heparin,and the treatment group treated as the same with control group plus atorvastatin（40 mg,qd oral at night）.The changes of blood lipid,hs-CRP and Hcy level of the two groups were compared 3 months after treatment.Results After treatment,there was significant improvement in angina symptoms,the effective rate was 93.33% in the treatment group higher than that of 75.56% in the control group（P0.05）.The levels of the TC,TG,LDL-C and hs-CRP in the two groups decreased significantly than that before treatment（P0.01）,the level of HDL-C was significantly higher than that before treatment（P0.01）,in the treatment group the changes were more obvious than that of the control group（P0.01 or P0.05）.In the control group,the level of Hcy after treatment showed only a downward trendency（P0.05）,but in the treatment group,the level of Hcy had significantly decreased compared with the control group or the level before treatment（P0.01）.Conclusion Atorvastatin may enhance the efficacy in treatment of unstable angina and reduce blood levels of hs-CRP and Hcy,thus reduce risk factors of the unstable angina and atherosclerosis.