阿托伐他汀对血脂水平正常的急性冠状动脉综合征患者早期炎症因子的影响

目的:观察正常血脂水平的急性冠状动脉综合征(ACS)患者早期白介素-6(IL-6)和高效C反应蛋白(hs-CRP)水平变化及阿托伐他汀早期治疗对其干预效果。方法:将血脂水平正常的ACS患者随机分为阿托伐他汀治疗组(20 mg/d×4周)和常规治疗对照组(各40例),另选择同期健康对照者40例作为健康对照组。分析比较组间及两组ACS患者治疗前后血清IL-6和hs-CRP水平变化。结果:两组ACS患者血脂水平与健康对照组比较差异无显著性,但其IL-6和hs-CRP水平均显著高于健康对照组(P<0.01);阿托伐他汀治疗2周时血脂水平无显著变化,但IL-6和hs-CRP水平显著降低(P<0.01),治疗4周时血清总胆固醇和低密度脂蛋白胆固醇及IL-6、hs-CRP水平均显著降低(P<0.05,P<0.01),且显著低于常规对照组(P<0.05)。结论:血脂水平正常的ACS患者同样存在明显的炎症反应,阿托伐他汀具有独立于调脂的抗炎作用,其快速抗炎作用在ACS患者早期治疗中可能具有重要意义。

Effect of atorvastin on inflammatory factors in patients of acute coronary syndrome with normal lipid level in early stage

Objective:To study the effect of atorvastatin on serum interleukin 6(IL-6) and high-sensitivity C-reactive protein(hs-CRP)in patients of acute coronary syndrome with normal lipid level in early stage.Methods:Eighty patients of ACS with normal lipid level were divided into routine controlled group(n=40) with conventional drugs and atorvastatin treaed group(n=40) with added atorvastatin 20 mg per day within 48 hours from onset.Forty healthy subjects were selected as normal controlled group.The level of IL-6 and hs-CRP were measured before and after 2 and 4 weeks treatment.Results:The lipid level in two ACS groups were similar to normal controlled group,but its level of IL-6 and hs-CRP were all increased significantly(P<0.01).After two weeks treatment with atorvastatin,the lipid level was not significantly changed,however,the level of IL-6 and hs-CRP were decreased significantly(P<0.01).After four weeks treatment with atorvastatin,the total cholesterol,low density lipoprotein cholesterol,IL-6 and hs-CRP were all lowered significantly(P<0.01).Conclusion:The inflammatory may esist in patients of ACS with normal lipid level.Atorvastatm possess anti-inflammatory effect which independent of its lipid lowering action,and the rapid anti-inflammatory effect of atorvastatiw might play an important role in the early treatment of ACS with normal lipid level.