两种剂量阿托伐他汀对冠心病患者踝臂指数和hs-CRP影响的比较

Effect of two different doses of atorvastatin on ankle-brachial index and hs-CRP in patients with coronary heart disease

目的:观察不同剂量阿托伐他汀治疗冠心病的疗效及其对踝臂指数(ABI)和高敏C反应蛋白(hs-CRP)的影响。方法:选择冠心病患者110例,随机分为40 mg组和10 mg组,每组各55例。10 mg组予以阿托伐他汀10mg/次,1次/晚,40mg组予以阿托伐他汀40mg/次,1次/晚。观察比较两组的血脂及治疗前后的ABI和hs-CRP的水平。结果:治疗后,两组的总胆固醇(TC),三酰甘油(TG)和低密度脂蛋白胆固醇(LDL-C)的水平均较治疗前显著降低(P<0.05或P<0.01),高密度脂蛋白胆固醇(HDL-C)水平较治疗前显著升高(P<0.05);与10 mg组比较,40 mg组LDL-C较10mg组降低更显著(P<0.05)。hs-CRP水平较治疗前也显著降低(P<0.01);与10 mg组比较,40 mg组hs-CRP水平下降更为显著(P<0.05)。而ABI水平治疗后较治疗前显著升高(P<0.01),与10 mg组比较,40 mg组ABI的改善更为显著(P<0.05)。结论:阿托伐他汀对冠心病患者的ABI和hs-CRP改善明显,而且40 mg组改善更显著。

AIM： To compare the influence of two different doses of atorvastatin on ankle-brachial index （ABI） and highly sensitive C-reactive protein （hs-CRP） in patients with coronary heart disease （CHD）. METHODS： One hundred and ten patients with CHD were randomly divided into observation group and control group, with 55 patients in each group. Conventional treatment for CHD was carried out in both groups for 6 months but at different doses ： 10 rng/day atorvastatin daily in one group and 40 nag/day atorvastatin daily in the other group. Serum lipid, ABI and hs-CRP before and after treatment were observed in the two groups. RESULTS： After treatment, TC, TG and LDL-C levels in both groups decreased significantly （P 〈 0. 05 or P 〈 0. 01 ）, whereas levels of HDL-C were significantly elevated （ P 〈 0.05 ）. Atorvastatin treatment group receiving 40 rag/day achieved a significantly better lowering of LDL-C than the group receiving 10 rag/day atorvastatin （ P 〈 0. 05 ）. The hs-CRP levels in both groups were significantly lower than before treatment （P 〈0. 01 ）, but patients treated with 40 mg/day atorvastatin had significantly lower hs-CRP level than patients treated with 10 mg/day atorvastatin （P 〈 0.05 ）. After 6 months, a significant improvement in ABI was observed in both groups （ P 〈 0.01 ） but the improvement in the group receiving 40 mg/day atorvastatin was significantly better than in the group receiving 10 mg/day atorvastatin （P 〈 0.05 ）. CONCLUSION： Atorvastatin improves ABI and decreases hs-CRP serum concentration in patients with coronary heart disease; treatment with 40 mg/day atorvastatin is more effective.