强化他汀治疗对急性冠脉综合征患者炎症因子和预后的影响
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Effects of intensive statin therapy on inflammatory factors and prognosis in patients with acute coronary syndrome
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    目的:探讨早期强化他汀治疗对急性冠脉综合征(ACS)患者炎症因子和预后的影响-方法:70例ACS患者随机分为常规他汀治疗组(A组)和强化他汀治疗组(B组),分别使用10 mg和40 mg阿托伐他汀进行治疗,检测治疗前和治疗1周时高敏C反应蛋白(hs-CRP)-血清淀粉样蛋白A(SAA)-基质金属蛋白酶 9(MMP-9)-纤维蛋白原(Fib)和血脂水平,随访两组60天心血管事件和不良反应-结果:两组治疗前后血脂水平无显著性变化(P > 0.05);A组hs-CRP-SAA-MMP-9水平有显著性下降(P < 0.05),B组4种炎症因子均有显著性下降(P < 0.05),且比A组下降得更低(P < 0.05);B组总心血管事件发生率较A组低(P < 0.05),两组均未发现明显不良反应-结论:早期强化他汀治疗能够降低炎症因子水平,减少心血管事件,具有很好的疗效和安全性-

    Abstract:

    Objective:To observe the effects of early intensive statin therapy on inflammatory factors and prognosis in patients with acute coronary syndrome(ACS). Methods:Total 70 patients with ACS were randomly divided into two groups:group A contained 35 patients administered with 10 mg/d atorvastatin besides of routine treatment,group B contained 35 patients administered with 40 mg/d atorvastatin besides of routine treatment. Before and after the treatment for one week,the plasma levels of inflammatory factors (hs-CRP,SAA,MMP-9,Fib) and blood lipid(TC,TG,LDL-C,HDL-C) were detected. All the patients were followed up for 60 days,and the incidence of cardiovascular disease and the adverse reaction of drug were detected. Results:Blood lipid levels had no significant changes in the two groups after treatment for one week(P > 0. 05). Except Fib,the inflammatory factors of hs-CRP,SAA and MMP-9 decreased significantly in group A after treatment with atorvastatin for one week(P < 0.05),and all the four inflammatory factors decreased significantly in group B(P < 0.05),and the changes were more significant in group B than that in group A (P < 0.05). The incidence of cardiovascular disease in group B was less than that in group A markedly (P < 0.05). No severe adverse effects were found in two groups. Conclusion:Early intensive statin therapy could reduce the levels of inflammatory factors,promote the stabilization of atherosclerotic plaque,reduce the incidence of cardiovascular disease and significantly improve prognosis of patients with ACS. Early intensive statin therapy has good effects and safety for patients with ACS.

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李毅亭,龙明智.强化他汀治疗对急性冠脉综合征患者炎症因子和预后的影响[J].南京医科大学学报(自然科学版),2009,29(10):1423-1426

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  • 收稿日期:2009-05-06
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