大剂量阿托伐他汀对急性冠状动脉综合征的调脂及抗炎作用
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The Effect of 40mg/d Atorvastatin on Patients with Acute Coronary Syndromes
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    目的探讨40 mg/d阿托伐他汀对急性冠状动脉综合征行经皮冠状动脉介入治疗术后患者的调脂及抗炎作用。方法将92例急性冠状动脉综合征行经皮冠状动脉介入治疗术后患者随机均分为两组,对照组给予阿托伐他汀10 mg/d,试验组给予阿托伐他汀40 mg/d,用药后4、12、24周检测两组患者血脂、血清中超敏C反应蛋白和基质金属蛋白酶9浓度,对比两组调脂及抗炎作用差异。结果①用药后12周,试验组患者血清总胆固醇较对照组显著降低(p<0.05);用药后24周,试验组患者血清总胆固醇和低密度脂蛋白胆固醇均较对照组显著降低(p<0.01)。②用药后12周,试验组患者血清基质金属蛋白酶9较对照组显著降低(p<0.01);用药后24周,试验组患者血清超敏C反应蛋白较对照组显著降低(p<0.05)。③降脂强度与病人的血清超敏C反应蛋白和基质金属蛋白酶9的浓度下降趋势呈线性正相关。④随访期内两组心脏事件发生率无统计学差异(p<0.05)。结论①服用阿托伐他汀40 mg/d安全可靠。②服用阿托伐他汀40 mg/d可显著提高急性冠状动脉综合征患者行经皮冠状动脉介入治疗术后血脂达标率。③服用阿托伐他汀40 mg/d对炎症因子血清基质金属蛋白酶9和血清超敏C反应蛋白具有更强抑制作用。

    Abstract:

    Aim To observe the lipoprotein regulation effect and the reuction of inflamatory infactors of 40 mg/d and 10 mg/d atorvastatin on patients with acute coronary syndromes(ACS) after percutaneous coronary intervention(PCI). Methods 92 patients with ACS after PCI were randomly devided into two groups: control group(atorvastatin 10 mg/d) and trial group(atorvastatin 40 mg/d).Serum concentration of ultrasensitive C-reactive protein(Us-CRP)and matrix metalloproteinases-9(MMP-9)were detected by enzyme linked immunosorbent assay(ELISA) to analyse the difference between two groups. Results Serum total cholesterol(TC) in trial group was lower than that in control group at 12th week(p<0.05),and serum TC and low density lipoprotein cholesterol(LDLC) in trial group were lower than those in control group at 24th week(p<0.01).Serum concentration of MMP-9 in trial group was lower than that in control group at 12th week(p<0.01).Moreover,serum concentration of Us-CRP in trial group was also lower than that in control group at 24 th week(p<0.05). The bivariate correlation analysis showed there were linear dependence association between the decline of serum concentration of Us-CRP and MMP-9 vs TC and LDLC.There was no significant difference of the patients' recurrent coronary artery events between the two groups. Conclusion ①Atorvastatin 40 mg/d was safe on Chinese patients.②Atorvastatin 40 mg/d increased the rate of reaching the lipoprotein regulation goal.③There were linear dependence association between the decline of serum concentration of Us-CRP,MMP-9 and the level of TC,LDLC.

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董少红,温隽珉,罗林杰,陈科奇,梁新剑,李宜富,刘华东,陈焕展,黄志昕.大剂量阿托伐他汀对急性冠状动脉综合征的调脂及抗炎作用[J].中国动脉硬化杂志,2006,14(7):613~616.

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  • 收稿日期:2005-07-20
  • 最后修改日期:2006-06-26
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