不同他汀类药物对冠脉综合征患者血清hs-CRP与颈动脉IMT的影响

The effects of different statins on serum hs CRP and carotid IMT of patients with coronary artery syndrome

目的探讨不同他汀类药物对冠脉综合征患者血清超敏C-反应蛋白(hypersensitive c-reactive protein,hs-CRP)与颈动脉内膜中层厚度(intima-media thickness,IMT)的影响。方法选取收治的冠脉综合征患者90例,根据采用不同他汀类药物将患者分为阿托伐他汀治疗组与瑞舒伐他汀治疗组,每组45例。采用酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)方法检测血清hs-CRP水平,超声测定颈动脉IMT。结果瑞舒伐他汀治疗组治疗总有效率明显高于阿托伐他汀治疗组(P<0.05)。治疗前,2组患者血清hs-CRP与颈动脉IMT比较差异无统计学意义(P>0.05),治疗1、3、6个月后,患者hs-CRP与IMT明显低于治疗前(P<0.05),其中瑞舒伐他汀治疗组hs-CRP与IMT明显低于阿托伐他汀治疗组,差异有统计学意义(P<0.05)。瑞舒伐他汀治疗组治疗1年内主要不良心脏事件(major adverse cardiac events,MACE)发生率明显低于阿托伐他汀治疗组,差异有统计学意义(P<0.05)。2组患者药物不良反应发生率比较差异无统计学意义(P>0.05)。结论瑞舒伐他汀用于改善冠脉综合征患者临床疗效作用更显著,可明显降低血清hs-CRP、颈动脉IMT,且降低MACE发生风险,值得临床推广应用。

Objective To investigate the effects of different statins on serum hypersensitive C-reactive protein（hsCRP） and carotid intima-media thickness（IMT） of patients with coronary artery syndrome. Methods A total of 90 patients with acute coronary syndrome who were treated in our hospital from March 2014 to March 2017 were divided into atorvastatin treatment group（n = 45） and rosuvastatin treatment group（n = 45） according to the type of statins. The serum levels of hsCRP level were detected by enzyme-linked immunosorbent assay（ELISA）,and carotid IMT was measured by ultrasound.Results The total effective rate in rosuvastatin treatment group was significantly higher than that in atorvastatin treatment group（P〈 0. 05）. There were no significantly differences in serum levels of hs CRP and carotid IMT between the two groups before treatment（P〈 0. 05）. At 1 m,3 m,6 m after treatment,the serum levels of hs CRP and carotid IMT in both groups were significantly lower than those before treatment（P〈 0. 05）,in which,the serum levels of hs CRP and carotid IMT in rosuvastatin treatment group were significantly lower than those in atorvastatin treatment group（P〈 0. 05）. The incidence rates of major adverse cardiac events（MACE） in rosuvastatin treatment group within 1 year after treatment were significantly lower than those in atorvastatin treatment group（P〈 0. 05）. However there was no significant difference in incidence rate of adverse drug reaction between the two groups（P〉 0. 05）. Conclusion Rosuvastatin has obvious therapeutic effects on coronary syndrome,which can obviously reduce serum levels of hs-CRP and carotid IMT,which can also reduce occurrence risk of MACE,therefor,which is worth using widely in clinical practice.