早期强化阿托伐他汀治疗对急性冠脉综合征患者高敏C-反应蛋白、脂联素的影响

Effect of early intensive atorvastatin treatment on hs-CRP and APN levels in patients with acute coronary syndrome

目的:探讨早期强化阿托伐他汀治疗对急性冠脉综合征(acute coronary syndrome,ACS)患者高敏C-反应蛋白(hypersensitive C reaction protein,hs-CRP)、脂联素(adiponectin,APN)的影响。方法:121例ACS患者随机分为普通治疗组(阿托伐他汀20 mg/d,59例)、强化治疗组(阿托伐他汀80 mg/d,62例),比较两组治疗前、治疗后24 h、72 h、1周的hs-CRP、APN水平;比较两组1周内的心血管事件发生率。结果:普通治疗组1周内心脏事件发生率明显高于强化治疗组(P<0.01)。与治疗前相比,治疗后24 h两组血清hs-CRP水平明显升高(P<0.01),且普通组明显高于强化组(P<0.05);治疗72 h、1周,两组的血清hs-CRP均显著下降(P<0.01),强化组下降幅度大于普通组(P<0.05)。与治疗前相比,治疗后24 h两组血清ANP水平明显降低(P<0.01),且普通组明显低于强化组(P<0.05);治疗72 h、1周两组的血清APN与治疗前相比均显著升高(P<0.01),强化组升高幅度大于普通组(P<0.05)。hs-CRP水平与APN水平呈负相关(r=-0.52,P<0.01)。结论:早期强化他汀治疗能够有效减少ACS患者近期心血管事件的发生,这一作用可能与降低hs-CRP水平,升高APN水平,抑制炎症反应有关。

Objective： This study aimed to investigate the effects of early intensive atorvastatin therapy on the levels of hypersensitive C reaction protein（hs-CRP） and adiponectin（APN） in hospitalized patients with acute coronary syndrome（ACS）.Methods： 121 hospitalized patients with ACS were randomly divided into the conventional therapy group（atorvastatin 20 mg/d,n=59） and the intensive treatment group（atorvastatin 80 mg/d,n=62）.We choosed 1 week for the period of observation in this study.All patients were administrated with standard medicine therapy and fed with salt-poor,low-fat diet.The serum concentrations of hs-CRP and APN were determined at four timepoints（baseline,at 24 hours,72 hours and after one week）;Cardiovascular events were monitored within a week.Results： Serum concentrations of hs-CRP were markedly lower than pre-treatment in both groups of patients at 72 hours and one week（P0.01）.Compared with conventional therapy,intensive atorvastatin therapy furtherly reduced serum hs-CRP concentrations（P0.05）.Concentrations of APN increased significantly at 72 hours and at one week,intensive atorvastatin therapy furtherly increased serum APN concentrations in comparision with conventional therapy（P0.05）.The levels of hs-CRP were negatively related to the expression of APN（r=-0.52,P0.01）.The occurrence of cardiovascular events observed during hospitalization in intensive therapy group is significantly lower than that of conventional treatment group（P0.01）.Conclusion： Early intensive atorvastatin treatment in patients with ACS could reduce cardiovascular events compared with the conventional treatment via its anti-inflammation.