阿托伐他汀对急性冠脉综合征患者血清高敏C反应蛋白和妊娠相关血浆蛋白-A水平的影响

目的探讨阿托伐他汀干预对急性冠脉综合征(ACS)患者血清高敏C反应蛋白(hs-CRP)和妊娠相关血浆蛋白-A(PAPP-A)水平的影响。方法采用酶联免疫吸附法测定不稳定型心绞痛患者(UAP,n=37)、急性心肌梗死患者(AMI,n=24)、稳定型心绞痛患者(SAP,n=29)和健康体检者(n=32)的hs-CRP和PAPP-A水平。同时将ACS患者(包括UAP和AMI组,n=61)随机分为常规治疗组(n=30)和阿托伐他汀干预组(阿托伐他汀10mg/d,n=31),并于治疗前后分别测定血清hs-CRP和PAPP-A水平。结果(1)hs-CRP和PAPP-A水平在UAP组(16.7±1.24)mg/L,(63.88±1.82)μg/L]、AMI组(18.52±1.96)mg/L,(66.41±1.24)μg/L]比SAP组(4.6±1.16)mg/L,(47.56±0.72)μg/L]、正常对照组(3.2±0.88)mg/L,(45.17±1.28)μg/L]显著升高(P<0.05)。(2)2周后,阿托伐他汀干预组血清hs-CRP和PAPP-A水平较治疗前明显降低hs-CRP(18.52±2.37)mg/Lvs.(3.58±1.33)mg/L;PAPP-A(67.83±2.15)μg/Lvs.(45.62±1.58)μg/L,P<0.05],且较常规治疗组治疗2周后亦有显著降低hs-CRP(3.58±1.33)mg/Lvs.(5.23±1.98)mg/L;PAPP-A(45.62±1.58)μg/Lvs.(51.35±2.15)μg/L,P<0.05]。结论阿托伐他汀干预可以减少急性冠脉综合征患者动脉粥样硬化斑块的炎症反应,具有稳定斑块的作用。

Effects of atorvastatin on serum hs-CRP, PAPP-A levels in acute coronary syndrome patients

Objective To investigate the effects of atorvastatin on serum high sensitive C-reactive protein(hs-CRP) and pregnancy-associated plasma protein-A(PAPP-A) levels in acute coronary syndrome(ACS) patients. Methods Serum hs-CRP and PAPP-A levels were measured in 37 patients with unstable angina(UAP),24 patients with acute myocardial infarction(AMI),29 patients with stable angina(SAP),and 32 healthy controls.Sixty-one ACS patients(UAP+AMI) were randomly assigned to conventional treatment group(n=30) or atorvastatin treatment group(n=31).Serum hs-CRP and PAPP-A levels were detected before and after treatment. Results ① hs-CRP and PAPP-A levels in ACS patients UAP:(16.7±1.24)mg,(63.88±1.82)μg/L;AMI:(18.52±1.96)mg/L,(66.41±1.24)μg/L]were significantly higher than those in stable angina patients (4.6±1.16) mg/L,(47.56±0.72) μg/L] and controls (3.2±0.88) mg/L,(45.17±1.28) μg/L](all P<0.05).②Serum hs-CRP and PAPP-A levels were significantly decreased after atorvastatin treatment in ACS group compared with baseline hs-CRP(18.52±2.37)mg/L vs.(3.58±1.33) mg/L;PAPP-A(67.83±2.15) μg/L vs.(45.62±1.58) μg/L;both P<0.05] and were also lower compared with conventional treatment group hs-CRP(3.58±1.33)mg/L vs.(5.23±1.98)mg/L;PAPP-A(45.62±1.58) μg/L vs.(51.35±2.15) μg/L,both P<0.05]. Conclusions Atorvastatin can reduce inflammatory reaction in atherosclerotic plaque in ACS patients and has an effect on plaque stabilization.