不同剂量辛伐他汀对急性心肌梗死患者炎性因子和血脂的影响

目的观察不同剂量辛伐他汀早期治疗急性心肌梗死患者对血清炎性因子、血脂水平及动脉粥样硬化病变消退程度的影响。方法43例急性心肌梗死患者分为A、B两组。A组(22例)口服辛伐他汀20mg/d,B组(21例)口服辛伐他汀40mg/d,治疗前后分别测定高敏C反应蛋白(hs-CRP)、可溶性白细胞分化抗原40配体(sCD40L)、基质金属蛋白酶-9(MMP-9)和血脂水平,随访12周和24周,颈动脉超声检查随访24周和48周。结果A组和B组患者血清hs-CRP、sCD40L、MMP-9和血脂水平在治疗后12周和24周时均有明显下降(P<0.05),且B组较A组作用更明显(P<0.05)。颈动脉内膜中层厚度、斑块积分随访48周后均有一定程度的下降,且以B组明显(P<0.05)。结论急性心肌梗死患者早期使用辛伐他汀治疗可显著降低血清炎性因子和血脂水平,并在一定程度上可阻止动脉粥样硬化病变的进展,且以大剂量为优。

The effect of different doses of simvastatin on the inflammatory markers and serum lipid in acute myocardial infarction patients

Objective To observe the effect of different doses of simvastatin on the inflammatory factors,serum lipid and the atherosclerosis regression in acute myocardial infarction patients.Methods Forty-three patients with acute myocardial infarction were divided into 2 groups(A,B group).The patients in group A(22 patients)were given orally simvastatin 20 mg/d,and the patients in group B(21 patients)were given orally simvastatin 40 mg/d.The serum level of high sensitivity C reactive protein(hs-CRP),soluble CD40 ligand(sCD40L),matrix metalloproteinase-9(MMP-9) and serum lipid were measured at the end of the 12th week and the 24th week.The carotid IMT and plaque score were measured at the end of the 24th week and the 48th week.Results In group A and group B patients,their serum levels of hs-CRP,sCD40L,MMP-9 and serum lipid were significantly decreased at the end of the 12th and the 24th week(P<0.05),and group B(simvastatin 40 mg/d) was superior to group A(simvastatin 20 mg/d)(P<0.05).The carotid IMT and plaque score in both groups tended to decrease at the end of the 48th week,and group B(simvastatin 40 mg/d) was superior to group A(simvastatin 20 mg/d,P<0.05).Conclusions When the acute myocardial infarction patients were treated early with simvastatin,the serum levels of inflammatory factors and serum lipid were significantly decreased,the progression of atherosclerosis might be inhibited to some extent,and the high dose of simvastatin might be better.