不同剂量瑞舒伐他汀短期干预对ACS患者血浆TM、hsCRP水平的影响(英文)

Influence of short-term intervention of different doses Rosuvastatin on plasma levels of TM and hsCRP in ACS patients

目的:探讨不同剂量瑞舒伐他汀短期干预对急性冠脉综合征(ACS)患者血浆血栓调节蛋白(TM)及高敏C反应蛋白(hsCRP)的影响。方法:选择ACS患者32例,随机均分为10mg瑞舒伐他汀组和20mg瑞舒伐他汀组,并选择非冠心病患者16例为正常对照组;采用酶联免疫吸附法定量测定两治疗组治疗前后及正常对照组入院时的TM及hsCRP水平,并观察两治疗组1个月内药物不良反应及心血管事件的发生率。结果:ACS患者治疗前血浆TM及hsCRP水平均明显高于正常对照组(P均<0.001);与治疗前比较,治疗7d后两组TM[10mg组:(54.09±52.45)μg/dl比(15.65±2.30)μg/dl,20mg组:(70.27±62.43)μg/dl比(19.86±5.49)μg/dl]及hsCRP[10mg组:(126.35±76.08)ng/ml比(54.85±45.30)ng/ml,20mg组:(125.35±60.29)ng/ml比(58.14±53.54)ng/ml]水平明显降低(P均<0.01);但两种治疗剂量对ACS患者血浆TM、hsCRP影响的差异无显著性(P均>0.05),且其随访期的药物不良反应发生率差异亦无显著性(P>0.05);瑞舒伐他汀20mg治疗组患者主要心血管事件发生率(MACE):再发心绞痛明显低于10mg组(18.75%比62.50%,P<0.01)。结论:早期强化他汀药物(20mg/d)治疗能降低ACS患者血浆血栓调节蛋白及高敏C反应蛋白水平,有效降低心血管事件的发生率,但不明显增加药物不良反应率。

Objective：To explore influence of short-term intervention of different doses rosuvastatin on plasma levels of thrombomodulin（TM） and high sensitive C reactive protein（hsCRP） in patients with acute coronary syndrome（ACS）.Methods：A total of 32 ACS patients were enrolled,randomly and equally divided into rosuvastatin 10mg group and rosuvastatin 20mg group,and another 16 patients without coronary heart disease were enrolled as normal control group.Enzyme linked immunosorbent assay（ELISA） was used to measure plasma levels of TM and hsCRP in two rosuvastatin groups before and after treatment and in normal control group at admission.Adverse drug reactions and incidence rates of cardiovascular events within one month were observed in two rosuvastatin groups.Results：Plasma levels of TM and hsCRP in two groups of ACS patients were both significantly higher than those of normal control group before treatment,P0.001 all;compared with before treatment,there were significant decrease in levels of TM [ 10mg group ：（54.09±52.45） μg/dl vs.（15.65±2.30） μg/dl,20mg group ：（70.27±62.43） μg/dl vs.（19.86±5.49） μg/dl ] and hsCRP [ 10mg group ：（126.35±76.08） ng/ml vs.（54.85±45.30） ng/ml,20mg group ：（125.35±60.29） ng/ml vs.（58.14±53.54） ng/ml ] in two rosuvastatin groups after treatment 7d,P0.01 all;But there were no significant differences in influences of two doses on plasma levels of TM and hsCRP in ACS patients,P〉0.05 all.There was no significant difference in incidence rate of adverse drug reactions between two rosuvastatin groups during follow-up（P〉0.05）;compared with rosuvastatin 10mg group,there was significant decrease in incidence rate of major adverse cardiovascular events（MACE）： Relapse angina pectoris（62.50% vs.18.75%,P0.01） in rosuvastatin20mg group.Conclusion：Early intensive statins medication（rosuvastatin20mg/d） can decrease plasma levels of thrombomodulin and high sensitive C reactive protein,and rosuvastatin20mg/d can effectively decrease incidence rate of cardiovascular events without significant increase incidence rate of adverse drug reactions in ACS patients.