高脂血症患者C-反应蛋白含量的变化及氟伐他汀对它的影响

Effects of fluvastatin on the levels of C-reactive protein and lipids in patients with hyperlipidemia

目的探讨高脂血症患者体内C-反应蛋白(CRP)浓度的变化及其与血脂之间的关系,并观察氟伐他汀对CRP和血脂的影响。方法随机选取62例高脂血症患者,给予氟伐他汀20 mg/晚,连续服用4周,治疗前后采用酶法测定血脂指标,免疫比浊法测定血清CRP浓度。结果90.3%的高脂血症患者的CRP水平超过正常范围,并且与所伴随的疾病无关。氟伐他汀能显著降低胆固醇(-7.49%)、甘油三酯(-14.32%)、低密度脂蛋白(-13.88%)、极低密度脂蛋白(-18.48%)和TC/HDL(胆固醇/高密度脂蛋白比值,-13.50%)水平(P<0.01),也使脂蛋白(a)浓度下降(-13.81%),并显著降低CRP浓度(-15.92%)。基础的CRP与各血脂指标和脂蛋白(a)之间无相关关系。氟伐他汀治疗后CRP与TC/HDL(r=0.62,P=0.041)和脂蛋白(a) (r=0.320,P=0.011)呈显著正相关;与高密度脂蛋白呈显著负相关(r=-0.288,P=0.023)。结论高脂血症患者的CRP水平增高,并且与所伴随的疾病无关;氟伐他汀除了能有效地调整血脂外,还能明显降低CRP浓度。CRP可作为预测动脉粥样硬化性心血管疾病危险的独立预报因子和评估治疗效果的指标。

Objective To observe the changes of C-reactive protein (CRP) level and its relationship with blood lipids, and the effects of fluvastatin on CRP and the lipids in patients with hyperlipidemia. Methods Serum levels of cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very-low-density lipoprotein cholesterol (VLDL-C) and lipoprotein(a) were measured by enzyme assay, and plasma CRP level by immunonephelometry before and after fluvastatin treatment (20 mg/d for 4 weeks) in patients with hyperlipidemia. Results CRP levels were above normal in 90.3% hyperlipidemia cases in spite of the various accompanying diseases. Fluvastatin treatment significantly reduced TC (-7.49%), TG (-14.32%), LDL (-13.88%), VLDL (-18.48%) and TC/HDL(-13.50%) levels (P<0.01), and also brought down Lp(a) concentration (-13.81%). CRP levels was very effectively reduced after the treatment (-15.92%, P<0.001). No association between basal CRP levels and basal lipids and Lp(a) concentrations was observed. Positive correlation of CRP, however, was observed after fluvastatin treatment with TC/HDL (r=0.62, P=0.041) and Lp(a) (r=0.320, P=0.011), while inverse relations were noted between CRP and HDL (r=-0.288, P=0.023). Conclusions CRP levels increases markedly in patients with hyperlipidemia, a fact that is independent of the accompanying diseases. In addition to modulating blood lipid levels, fluvastatin also reduces CRP level, the latter possibly serving as an independent predictive factor for atherosclerotic cardiovascular diseases and also as an indicator for estimating the effectiveness of the treatment.