高脂血症患者血清C反应蛋白水平影响辛伐他汀降脂效果的研究

Study on hyperlipidemia serum C-reactive protein level in fluence of simvastatin lipid-lowering effect

目的探讨高脂血症患者血清C反应蛋白(CRP)水平对辛伐他汀降脂效果的影响。方法选取2016年1月1~31日在我院就诊的高血脂症患者90例,根据血清CRP水平分为3组,正常CRP组(≤5mg/L)30例,中度CRP组(5~15mg/L)30例,高度CRP组(CRP>15mg/L)30例,所有入组的患者在控制脂肪饮食加运动综合疗法的基础上,均给予口服辛伐他汀20mg/d,连续治疗12周。对比组间及组内治疗前后血脂、CRP水平变化。结果治疗12周后,正常CRP组和中度CRP组高密度脂蛋白胆固醇(HDL-C)均较治疗前明显上升(P<0.05),甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)和CRP水平均较治疗前显著降低(P<0.05);且正常CRP组比中度CRP组血脂上述各项指标变化更显著,差异有统计学意义(P<0.05),然而中度CRP组CRP水平下降幅度比正常CRP组明显,差异有统计学意义(P<0.05)。高度CRP组治疗前后血脂各项指标变化不明显,差异无统计学意义(P>0.05),但CRP水平较治疗前下降幅度显著(P<0.05),且下降幅度优于中度CRP组,差异有统计学意义(P<0.05)。结论辛伐他汀可明显降低高脂血症患者血脂、降低患者体内炎症水平,但血清CRP浓度较高的高脂血症患者,其降脂效果较差,说明不同水平CRP与辛伐他汀降脂效果之间有密切的关联。可根据CRP水平对辛伐他汀降脂效果的影响来指导临床用药,以期达到满意的疗效及安全性。

Objective To study the influence of hyperlipidemia serum c-reactive protein （CRP） levels in simvastatin lipid-lowering effect. Methods 90 cases of patients with hyperlipidemia cured in our hospital from January 1 to 31,2016 were selected.According to the serum CRP level,they were divided into normal CRP group（ ≤ 5mg/L） with 30 cases,moderate CRP group（5-15mg/L）with 30 cases and high CRP group（CRP 〉 15mg/L） with 30 cases. All the patients in the three groups were treated with oral simvastatin 20mg/day,treatment of 12 weeks in a row,on the basis of fat control diet plus exercise and comprehensive therapy.The blood lipid,CRP level changes before and after treatment of the three group were compared. Results 12 weeks after treatment,the high-density lipoprotein cholesterol（HDL-C） normal in CRP group and moderate CRP group were significantly increased（P〈 0.05）,triglyceride （TG）,total cholesterol（TC）,low-density lipoprotein cholesterol（LDL-C）and CRP levels were significantly lower than before treatment（P 〈 0.05）.And blood fat the above-mentioned index change in normal CRP than moderate CRP group was more significant,the difference was statistically significant（P 〈 0.05）.However level declines of moderate CRP group were more significant than those of normal CRP group,the differences were statistically significant （P 〈 0.05）.There was no significant change on the indicators of blood fat before and after the treatment of high CRP group does not change slgnificantly,there was no statistically significant differenc（P 〉 0.05）,but CRP levels before the treatment decreased significantly（P 〈 0.05）,and the decline was better than that of moderate CRP group,the difference was statistically significant （P 〈 0.05）. Conclusion Simvastatin can significantly reduce blood fat,andreduce hyperlipemia patients level of inflammation in the body.But for the hyperlipidemia patients with the high serum CRP,its lipid-lowering effect is poorer,which shows that different levels of CRP and simvastatin has a close connection between lipid-lowering effect.According to the CRP level of simvastatin lipid-lowering effect,it can guide the clinical medication,in order to achieve satisfactory efficacy and safety.