阿托伐他汀对急性ST段抬高型心肌梗死患者血清淀粉样蛋白A和脂联素水平的影响

目的观察不同剂量阿托伐他汀干预对急性ST段抬高型心肌梗死（STEMI）患者血清淀粉样蛋白A（SAA）及脂联素（APN）水平的影响。方法采用酶联免疫吸附法测定急性ST段抬高型心肌梗死患者（63例）、健康体检者（30例）SAA和APN水平。将STEMI患者随机分为阿托伐他汀20 mg干预组（n=31）和阿托伐他汀40 mg干预组（n=32）,并于治疗前后分别测定SAA和APN水平。结果干预前SAA水平在2 0 mg组和4 0 mg组均比健康组高,APN水平在2 0 mg和4 0 mg组比健康组低（P〈0.05）;2周后SAA在20 mg组和40 mg组均较干预前降低,APN在20 mg和40 mg组均较干预前升高（P〈0.05）;干预后40 mg组与2 0 mg组比较SAA和APN的浓度变化幅度更大（P〈0.0 5）。STEMI患者的血清淀粉样蛋白A与脂联素呈负相关（r=-0.478,P〈0.05）。结论 STEMI患者SAA水平升高,APN水平降低;阿托伐他汀干预后可降低SAA浓度,升高APN浓度;大剂量可使SAA和APN浓度变化更大。

Influence of Atorvastatin on Levels of Serum Amyloid A and Adiponectin in ST Elevated Myocardial Infarction

Objective To observe the influence of the different doses of atorvastatin on serum amyloid A（SAA） and adiponectin（APN） in patients（pts） with ST elevated myocardial infarction（STEMI）.Methods Sixty-three pts with STEMI were randomly assigned to atorvastatin 20 mg group（A group,n=31） and atorvastatin 40 mg group（B group,n=32）.Thirty healthy subjects were selected as the control group.The serum SAA and APN levels were detected before and after treatment.Results Before intervention,the serum SAA levels in A group and B group were higher than that in the control group,while the APN levels in A group and B group were lower than that in the control group（P0.05）.After treatment of two weeks,the serum SAA levels in A group and B group were decreased,while the APN levels in A group and D group were increased（P0.05）.After treatment,the concentration change of serum SAA and APN in B group were more than that in A group（P0.05）.The serum SAA level was negatively correlated to the serum APN level in STEMI group（r=-0.478,P0.05）.Conclusion The baseline serum levels of serum SAA was higher and APN was lower in STEMI group.Atorvastatin could decrease the level of serum SAA and increased the level of serum APN.Pts with STEMI had more benefit from the use of higher dose of atorvastatin.