强化他汀治疗对不稳定型心绞痛患者血清超敏C反应蛋白及可溶性CD40配体L的影响

The impact of intensive statin therapy on stability of coronary plaques in unstable angina patients

目的观察强化他汀治疗不稳定型心绞痛的效果及可能机制。方法将130例不稳定型心绞痛患者随机分为治疗1组(瑞舒伐他汀钙片10 mg,1次/d,50例)、治疗2组(瑞舒伐他汀钙片20 mg,1次/d,50例)和对照组(常规治疗,30例),测定治疗前及治疗后1周、4周、8周时血清超敏C反应蛋白(hs-CRP)、可溶性CD40配体L(sCD40L)、血脂、肝功能等指标,主要心血管事件(MACE)的发生率以及瑞舒伐他汀的药物不良反应情况。结果与对照组相比较,治疗1组和治疗2组治疗后1周、4周、8周血清hs-CRP、sCD40L、LDL-C水平均降低(P<0.05),治疗1组和治疗2组之间治疗后8周hs-CRP、sCD40L差异有统计学意义(P<0.01)。结论不稳定型心绞痛患者强化他汀治疗,可能通过抗炎、改善内皮、稳定斑块等作用而最终获益。

Objective To investigate the clinical effect and significance of intensive statin on serum hs-CRP and soulable CD40L in unstable angina（UA） patients.Methods 130 UA patients were randomly divided into three groups.The control group（n=30） was given the routine medicine,and the other two therapy groups were administered rosuvastatin with 10 mg（group1） or 20 mg（group2） qd for 8 weeks.Levels of serum hs-CRP,sCD40L and lipid,and the incidences of major adverse cardiovascular events were determined before and after treatment.Results Compared with the control group,the levels of serum hs-CRP,CD40L,LDL-C and the rate of angina attacks were significantly decreased in treatment group 1 and group 2（n=50,P0.05）.There was significant difference between group1 ang group2（P0.01）.Conclusion Intensive treatment of rosuvastatin is beneficial for UA patients.The possible mechanisms include anti-inflammation,improving the endothelium and stabilizing of plaque.