瑞舒伐他汀对急性冠状动脉综合征患者血清载脂蛋白的影响

Effects of rosuvastatain on apolipoprotein A1 and B of patients with acute coronary syndrome

目的探讨瑞舒伐他汀对急性冠状动脉综合征（ACS）患者血清载脂蛋白A1（ApoA1）、载脂蛋白B（ApoB）以及ApoB／ApoA1的影响。方法选取我院ACS住院患者150例，应用随机数字表随机分为3组：A组，瑞舒伐他汀5mg每晚顿服；B组，瑞舒伐他汀10mg每晚顿服；C组，辛伐他汀20mg每晚顿服。分别于服药前和服药第4、8周采血检测总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C）、ApoA1、ApoB。比较3组患者治疗前后血脂水平的变化。结果（1）组内比较：治疗4周时，3组患者TC、LDL—C较治疗前显著降低（P均〈0．05）；治疗8周时，3组患者TC、LDL．C、ApoB、ApoB／ApoA1较治疗前显著降低，HDL—C、ApoA1显著升高（P均〈0．05）。（2）组间比较：治疗8周时，B组TC、LDL—C、ApoB、ApoB／ApoA1较A、C组显著降低，HDL-C、ApoA1显著升高（P均〈0．05）。（3）3组患者肝损害发生率差异无统计学意义（χ^2=1．25，P〉0．05）。结论10mg／d瑞舒伐他汀降低ACS患者ApoB、升高ApoA1的效果优于5mg／d瑞舒伐他汀及20mg／d辛伐他汀，10mg／d瑞舒伐他汀更有利于降低ApoB／ApoA1水平，更能有效地控制ACS的发生。

Objective To observe the effect of Rosuvastatin on apolipoprotein A1 （Apo A1 ）, apolipoprotein B（Apo B） and Apo B/Apo A1 patients with acute coronary syndrome. Methods One hundred and fifty hospitalized patients with acute coronary syndrome were randomly divided into three groups, A group （Rosuvastatain ,5 rag/d）, B group（ Rosuvastatain, 10 mg/d）, and C group（ Simvastatin,20 mg/d）. Before and at 4,8 weeks after treatments tested the three groups＇ cholesterol（TC）, glycerin（TG）, high density lipoprotein cholesterol（ HDL-C）, low density lipoprotein cholesterol（ LDL-C）, Apo A1, Apo B. Compare the blood lipids aforementioned before and after treatments in three groups. Results （ 1 ） After treatments for 4 weeks,TC, LDL- C in three groups are significant lower than before （P 〈 0. 05 ）. After treatments for 8 weeks, TC, LDL-C, Apo B, Apo B/Apo A1 of three groups are lower than before and HDL-C ,Apo A1 is higher than before （P 〈 0.05 ）. （2） After treatments for 8 weeks, comparing to A and C groups,TC, LDL-C, Apo B , Apo B/Apo A1 in B group were lower while HDL-C, Apo A1 were higher （ P 〈 0. 05 ）. （ 3 ） The incidences of liver damage has no significant differences among three groups （ χ^2 = 1.25, P 〉 0. 05 ）. Conclusion Effects of 10 mg/d rosuvastatain were better than 5 mg/d rosuvastatain and 20 mg/d simvastatin in increasing Apo A1 and decreasing Apo B, Apo B/ Apo A1, and then effectively control of ACS.