阿托伐他汀钙对冠心病患者胆红素水平的影响及胆红素水平变化与CRP、血尿酸的相关分析

Relationship between bilirubin level and C-reactive protein and serum uric acid after using atorvastatin

目的探讨初次服用不同剂量阿托伐他汀钙的冠心病患者血清胆红素水平变化,并将胆红素水平变化同C反应蛋白(CRP)、血尿酸进行相关性分析。方法回顾性分析心脏内科初诊冠心病患者276例,根据冠心病患者实际服用阿托伐他汀钙的剂量,分为20 mg/d组(158例)和40 mg/d组(118例)。收集服药前后临床资料,血清胆红素、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、CRP、血清尿酸水平进行对比分析,同时观察阿托伐他汀钙治疗1个月后上述指标的变化水平,并进行相关性分析。结果两不同剂量组服药后与服药前相比,血清总胆红素水平及直接胆红素水平均呈显著性升高(P<0.05),间接胆红素水平前后无明显差异。CRP水平与血清尿酸水平明显降低(P<0.05)。两不同剂量组间比较,40 mg/d组患者血清总胆红素[服药前:(10.3±2.0)μmol/L;服药后:(13.7±2.2)μmol/L]、直接胆红素[服药前:(3.0±1.1)μmol/L;服药后:(4.6±1.3)μmol/L]升高更显著(P<0.05),但间接胆红素水平未发生明显变化。同时40 mg/d组CRP及血清尿酸水平较20 mg/d组降低水平更明显(P<0.05)。直接胆红素变化与患者CRP、血清尿酸水平均呈负相关性。结论阿托伐他汀钙治疗冠心病可促使血清胆红素水平升高,同时降低CRP和血清尿素水平;且高剂量较低剂量作用更显著。血清胆红素水平的升高同CRP降低、血尿酸水平降低呈负相关。

AIM To investigate the relationship of the serum bilirubin level and related risk factors of coronary atherosclerosis in patients with coronary heart disease （CHD） using atorvastatin for the first time. METHODS According to inclusion and exclusion criteria, 276 patients who were first diagnosed with CHD were screened and randomly divided into 20 mg/day （158） and 40 mg/day （118） treatment groups. Changes of the above indexes were observed and its correlation was analyzed after 1 month treatment with atorvastatin calcium. Serum bilirubin, C-reactive protein （CRP）, serum uric acid （SUA） level and baseline data were detected. RESULTS Whether using 20 mg/day or 40 mg/day of atorvastatin calcium, serum total bilirubin and direct bilirubin levels were significantly increased （P〈0.05） compared with those before treatment, whereas indirect bilirubin levels had no significant difference. CRP and SUA levels were significantly decreased （P〈0.05）. Compared with the two groups, serum total bilirubin and direct bilirubin levels in the 40 mg/day group were significantly higher than in the 20 mg/day group （P〈0.05）, but indirect bilirubin levels had no significant difference between groups. CRP and SUA levels in the 40 mg/day group were significantly decreased than in the 20 mg/day group （P〈0.05）. The rate of change of direct bilirubin was significantly correlated with the level of CRP and SUA. Comared with the two groups, before using atorvastatin, serum total bilirubin in the 40 mg/day group was （10.3±2.0） μmol/L. After treatment it was （13.7±2.2） μmol/L. Direct bilirubin levels before treatment were （3.0±1.1）μmol/L and after treatment were （4.6±1.3）μmol/L. CONCLUSION Atorvastatin calcium in the treatment of CHD can increase the level of serum bilirubin and significantly reduce the levels of CRP and SUA. The higher dose had a more significant effect. The increase of serum bilirubin level was correlated with the decrease of CRP and SUA.