强化他汀方案对急性冠状动脉综合征炎症状态的影响及安全性研究

Impact of Intensive Atorvastatin Treatment on Inflammatory Markers in Patients with Acute Coronary Syndrome and Its Safety

目的探讨他汀强化治疗对急性冠状动脉综合征(ACS)炎症状态的影响和安全性。方法 ACS患者96例,诊断后第1天立即服用阿托伐他汀钙片80 mg,第2～4天80 mg/d,第5天开始40 mg/d直至出院。观察治疗前及治疗3 d后血清TC、TG、HDL-C、LDL-C、白介素-6(IL-6)、基质金属蛋白酶-9(MMP-9)和超敏C-反应蛋白(hs-CRP)及血尿素氮(BUN)、肌酐(Cr)、谷草转氨酶(AST)浓度。结果治疗后TC、HDL-C、LDL-C、Cr、BUN浓度与治疗前比较,差异无统计学意义(P>0.05);治疗后TG、IL-6、MMP-9、hs-CRP浓度较治疗前明显降低(P<0.05);治疗后AST轻度增高5例占5.2%,无严重肾功能不全、心肌炎、横纹肌溶解等不良反应。结论强化他汀方案治疗ACS能使血清炎症因子水平下降,无明显副作用。

Objective To investigate the effects of intensive atorvastatin treatment on inflammatory markers in patients with acute coronary syndrome （ACS） and its safety. Methods Ninety-six consecutive patients received 80 mg of atorvastatin on the first day when the diagnosis was confirmed and maintained the dosage of 80 mg daily for the next three days, and then 40 mg daily before discharge. The serum levels of triglyceride （ TG）, total cholesterol （ TC ）, high density lipoprotein cholesterol （ HDL-C ）, low density lipoprotein cholesterol （ LDL-C ）, intedeukin-6 （ IL-6 ）, matrix metalloproteinase 9 （MMP-9）, high-sensitivity C-reactive protein （hs-CRP） were measured as well as the levels of blood urea nitrogen （ BUN）, creatinine （ Cr）, glutamic-oxaloacetic transaminase （AST） before treatment and three days after treatment. Results The levels of TG,HDL-C ,LDL-C,Cr and BUN after treatment showed no significant difference compared with those before treatment （P 〉 0.05 ）. The levels of TG, IL-6, MMP-9 and hs-CRP decreased significantly after treatment compared with those before treatment （P 〈 0.05 ）. After treatment, there were 5 cases of slightly increased AST which took 5.2 percent, and the adverse reactions such as severe renal dysfunction,myocarditis and rhabdomyolysis were not observed. Conclusion Intensive atorvastatin treatment may reduce serum levels of inflammatory factors and of no obvious side effects on patients with ACS.