阿托伐他汀对不同 Gensini 评分冠心病患者的治疗效果及其对C反应蛋白水平的影响

Effect of atorvastatin in the treatment of coronary heart disease patients with different Gensini score and its ;influence on hs-CRP level

目的：探讨阿托伐他汀对不同Gensini 评分冠心病患者的临床疗效及其对超敏C 反应蛋白（hs-CRP）水平的影响。方法选取2011年3月至2015年9月收治的冠心病患者120例为研究对象，按不同Gensini评分分为 A 组（Gensini 评分＜40分）、B 组（Gensini 评分40～60分）、C 组（Gensini 评分＞60～80分）、D组（Gensini评分＞80分），每组30例，均给予阿托伐他汀治疗，比较四组临床疗效及总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、hs-CRP水平的变化。结果治疗后Gensini评分越低，疗效越好，A组、B组、C 组、D组总有效率分别为96．7％、86．7％、76．6％、56.7％，四组总有效率差异有统计学意义（χ2＝7．362，P＜0．05）；治疗后，四组TG、TC、HDL-C、LDL-C指标均有所改善，A组改善幅度优于B组，B组改善幅度优于C组，C组改善幅度优于D组，差异均有统计学意义（F＝6．253、6．258、5．856、6．259，均 P＜0．05）；治疗后 A 组、B 组、C 组、D 组 hs-CRP 分别为（8．2±3．9）mg／L、（11.9±6．9）mg／L、（19．2±9．3）mg／L、（24．5±11．6）mg／L，四组hs-CRP水平均有所下降，A组治疗后hs-CRP水平低于B、C、D组，B组治疗后hs-CRP水平低于C、D组，C组治疗后hs-CRP水平低于D组，差异均有统计学意义（t＝12．651、9．185、4．982、3．030，均P＜0．05）。结论冠心病患者血清hs-CRP水平较高，hs-CRP水平与Gensini评分呈正相关。

Objective To study the effect of atorvastatin on the levels of high sensitive C-reactive protein （hs-CRP）in coronary heart disease（CHD）patients with different Gensini score.Methods 120 cases of CHD from March 201 1 to September 2015 in our hospital were selected as the research subjects.According to the different Gensini scores,they were divided into group A （Gensini score 〈40 ）,group B （Gensini score 40 -60 ）,group C （Gensini score 60 -80 ）,group D （Gensini score 〉80 ）,with 30 patients in each group.All patients were given atorvastatin treatment,the therapeutic effect of the four groups,the total cholesterol（TC）,three glycerol（TG）,high density lipoprotein cholesterol（HDL-C）,low density lipoprotein cholesterol（LDL -C）and hs -CRP levels after treatment were compared.Results After treatment,the lower the Gensini score,the better curative effect,four groups had statistically significant difference in the therapeutic effects（P〈0.05）,and the total effective rates of group A,B, C and D were 96.7%,86.7%,76.6%,56.7%.After treatment,the TG,TC,HDL-C,LDL-C in four groups were improved,A group improved significantly better than the B group,B group improved better than those of C group,C group improved better than those of D group,the differences were statistically significant（F=6.253,6.258,5.856, 6.259,all P〈0.05）.After treatment,the levels of hs-CRP in group A,B,C and D were （8.2 ±3.9）mg/L,（11.9 ± 6.9）mg/L,（19.2 ±9.3）mg/L,（24.5 ±11.6）mg/L,the hs-CRP levels of four groups were lower,hs-CRP level after treatment in group A was lower than that of B,C,D groups;and hs-CRP level after treatment in group B was lower than that of group C,D;hs-CRP level of C group after treatment was lower than that of group D.The differ-ences were statistically significant（t=12.651,9.185,4.982,3.030,all P〈0.05）.Conclusion The level of serum hs-CRP in patients with CHD is higher,and the level of hs-CRP is positively correlated with the Gensini score.