不同剂量瑞舒伐他汀对急性冠状动脉综合征患者血脂和炎性因子的影响及安全性

Effect and Safety of Different Doses of Rosuvastatin on Serum Lipids and Inflammatory Factors of ACS Patients

目的探讨不同剂量的瑞舒伐他汀对急性冠状动脉综合征(ACS)患者血脂和炎性因子水平的影响及其安全性。方法选择2013年6月至2014年12月北京市顺义区医院心内科收治的84例ACS患者作为研究对象,采用随机数字表法将患者分为高剂量组(42例)和低剂量组(42例)。两组患者均给予抗血小板聚集以及扩血管等常规治疗,在此基础上高剂量组给予20 mg瑞舒伐他汀口服治疗,每晚1次;低剂量组在常规治疗的基础上给予10 mg瑞舒伐他汀口服治疗,每晚1次。比较两组患者治疗前后血脂水平[总胆固醇、三酰甘油、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]和炎性因子[高敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)]水平的变化情况,并比较其安全性。结果治疗后,高剂量组总胆固醇、LDL-C、hs-CRP、IL-6的水平较治疗前显著降低[(4.2±1.0)mmol/L比(5.5±0.8)mmol/L、(1.7±0.6)mmol/L比(3.0±0.8)mmol/L、(3.1±1.0)mg/L比(7.2±2.2)mg/L、(17.9±3.0)ng/L比(30.1±5.0)ng/L],低剂量组总胆固醇、LDL-C、hs-CRP、IL-6的水平也较治疗前显著降低[(4.6±0.6)mmol/L比(5.5±0.7)mmol/L、(2.0±0.6)mmol/L比(3.0±0.7)mmol/L、(4.0±0.9)mg/L比(7.2±2.2)mg/L、(20.4±4.2)ng/L比(29.3±5.2)ng/L],且高剂量组低于低剂量组,差异有统计学意义(P<0.05);两组患者的HDL-C的水平均较治疗前显著升高,且高剂量组高于低剂量组[(1.4±0.4)mmol/L比(1.2±0.3)mmol/L],差异有统计学意义(P<0.05)。高剂量组有4例患者出现肝功能异常,低剂量组有3例,两组均未出现其他严重不良反应。结论瑞舒伐他汀可有效降低ASC患者的血脂水平和炎性因子水平,高剂量的效果明显优于低剂量,且不增加不良反应。

Objective To investigate the effect and safety of different doses of rosuvastatin on serum lipids and inflammatory factors of acute coronary syndrome（ ACS） patients. Methods Total of 84 patients with ACS in Beijing Shunyi District Hospital from Jun. 2013 to Dec. 2014 were included in the study and divided into high-dose group（ 42 cases） and low-dose group（ 42 cases） according to random number table method,both groups were given conventional treatment like anti-platelet aggregation and vasodilator,and the high-dose group was given 20 mg rosuvastatin oral treatment,once a night,and the low-dose group was given10 mg rosuvastatin oral treatment,once a night. The lipid levels[total cholesterol,triglycerides,high density lipoprotein cholesterol（ HDL-C）,low-density lipoprotein cholesterol（ LDL-C） ] and inflammatory factors[high-sensitivity C-reactive protein（ Hs-CRP）,interleukin-6（ IL-6） ] before and after treatment of the two groups were compared,as well as the safety. Results After treatment,the total cholesterol,LDL-C,hs-CRP,IL-6 of the high-dose group were lower than before treatment [（ 4. 2 ± 1. 0） mmol / L vs（ 5. 5 ± 0. 8） mmol / L,（ 1. 7 ± 0. 6） mmol /L vs（ 3. 0 ± 0. 8） mmol/L,（ 3. 1 ± 1. 0） mg/L vs（ 7. 2 ± 2. 2） mg/L,（ 17. 9 ±3. 0） ng / L vs（ 30. 1 ± 5. 0） ng / L ],those of the low-dose group were lower than before treatment too[（ 4. 6 ± 0. 6） mmol/L vs（ 5. 5 ± 0. 7） mmol/L,（ 2. 0 ± 0. 6） mmol/L vs（ 3. 0 ± 0. 7） mmol/L,（ 4. 0 ±0. 9） mg / L vs（ 7. 2 ± 2. 2） mg / L,（ 20. 4 ± 4. 2） ng / L vs（ 29. 3 ± 5. 2） ng / L],and the high-dose group was significantly lower than the low-dose group,the difference was statistically significant（ P〈 0. 05）. The levels of HDL-C of the two groups were significantly higher than before,and the high-dose group was higher than the low-dose group,the difference was statistically significant（ P〈 0. 05）. In the high-dose group,there were four patients with abnormal liver function,in the low-dose group there were 3 patients,and no other serious adverse reactions happened in either group. Conclusion Rosuvastatin can effectively lower the lipid levels and inflammatory factors,without increasing the adverse reaction of ACS patients,and the effect of high dose is better than low dose.