血清C反应蛋白水平与不同剂量辛伐他汀降脂效果的相关性分析

Correlation analysis between serum c-reactive protein levels and lipid-lowering effect of simvastatin with different doses

目的探讨高血脂症患者血清C反应蛋白(CRP)水平与不同剂量辛伐他汀降脂效果存在交互影响,并进行对比分析,以期更好地为临床治疗方案提供参考。方法选取2016年6月1~30日在我院就诊的高血脂症患者120例,根据血清CRP不同水平分为3组,正常CRP组(≤5mg/L)40例,中度CRP组(5~15mg/L)40例,高度CRP组(CRP>15mg/L)40例。三组患者均予以在控制脂肪饮食加运动综合疗法的基础上,按随机数字表法对三组患者组内又分为高剂量组和低剂量组各20例,高剂量组均给予辛伐他汀分散片40mg/d,低剂量组均给予辛伐他汀分散片20mg/d,均连续口服12周。对比各组治疗前后血脂、血清CRP水平变化,同时采用多元线回归分析各指标间的相关性。结果治疗12周后,正常CRP组及中度CRP组各组内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水平均较治疗前明显降低(P<0.05),且正常CRP高剂量组降脂效果更明显(P<0.01)。高度CRP组各组内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),而CRP水平较治疗前明显降低(P<0.05),特别是高剂量组CRP水平下降更显著,且下降幅度优于其他各组,差异有统计学意义(P<0.01)。三组患者治疗后组间及组内两两比较,降脂效果和抗炎作用与给药剂量及患者体内CRP水平呈交互相关。结论辛伐他汀能明显降低正常和中度CRP水平高脂血症患者血脂、体内炎症水平,尤其是低CRP水平高剂量组降脂效果更显著,然而对高浓度CRP高脂血症患者来说,降脂效果不明显,但降低血清CRP水平明显,特别是高剂量组下降幅度更显著,且优于正常CRP组和中度CRP组,说明CRP水平与他汀类药物量效有着密切关联,证实CRP与辛伐他汀降脂效果之间存在交互效应。本研究结果为今后的临床治疗心脑血管疾病找到新的靶点提供了可靠的依据。

Objective To explore the interaction exists of hyperlipemia patients serum c-reactive protein （CRP） level and different doses of simvastatin lipid-lowering effect exist,and to compare and analyze, in order to better provide reference for clinical treatment. Methods 120 cases of patients with hyperlipidemia cured in our hospital from June 1,2016 to June 30, 2016 iwere selected.According to different levels of serum CRP,they were divided into normal CRP group（ ≤5mg/L）with 40 cases, moderate CRP group（5 - 15mg/L） with 40 cases, high CRP group （CRP 〉 15mg/L） with 40 cases.All the patients in the three groups were to control fat diet plus exercise,on the basis of comprehensive therapy of three groups,according to random number table method,the three groups were divided into high dose subgroup and low dose subgroup with 20 cases.Patients in high dose subgroup were given simvastatin tablets 40 mg/day,and patients in low dose subgroup were given simvastatin tablets 20 mg/day,both oral 12 weeks in a row.Before and after treatment,the blood fat,serum CRP level changes of each group were compared.At the same time,multivariate linear regression analysis was used to analyze the correlation among the indexes. Results 12 weeks after treatment,high-density lipoprotein cholesterol （HDL-C） of normal CRP group and moderate CRP 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 high-dose group reduced more significantly （P 〈 0.01）.High CRP group did not change significantly between subgroups within the lipid indicators before and after the treatment,there was no statistically significant difference（P 〈 0.05）.And CRP levels were significantly lower than before treatment （P 〈 0.05）,especially in high dose group of CRP level decreased more significantly,and the decline was superior to other groups, the difference was statistically significant（P 〈 0.01）.Three groups of patients after treatment between groups and subgroup,lipid-lowering effects and anti-inflammatory effects and medicine dose and the CRP level in patients showed cross correlation. Conclusion Simvastatin can significantly reduce the normal and moderate CRP levels in patients with hyperlipidemia blood lipids,level of inflammation in the body,especially the lipid-lowering effect of low CRP levels high dose group is more significant.But the lipid-lowering effect of high concentration of CRP in patients with hyperlipidemia is not obvious,however,the effect in reducing the serum CRP level is obvious,especially in high dose group it decreases more significantly.And it is superior to Normal CRP group and moderate CRP group.It shows that CRP levels has close correlation to the effects of statins.It confirmes that CRP has interaction effect with simvastatin interaction effect.The results for future clinical treatment of disease of heart head blood-vessel finds new targets provides a reliable basis.