阿托伐他汀对急性冠状动脉综合征患者不对称二甲基精氨酸的影响

目的 研究阿托伐他汀对急性冠状动脉综合征(ACS)患者不对称二甲基精氨酸(ADMA)的影响及意义.方法 随机选择ACS患者78例,入选后再随机分为阿托伐他汀组(他汀组)39例,常规治疗组(常规组)39例;随机选取我院同期的健康体检者40例作对照组.测定每组治疗前后血脂和ADMA水平.结果 ①急性心肌梗死(AMI)组ADMA浓度(1.09±0.36)μmol/L高于不稳定型心绞痛(UAP)组(0.91±0.22)μmol/L(P<0.01),AMI组和UAP组ADMA浓度高于正常对照组(0.57±0.12)μmol/L(P<0.01).②他汀组经阿托伐他汀治疗后,ADMA、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)均低于治疗前,分别为ADMA(0.67±0.25)μmol/L vs(1.02±0.32)μmol/L,TC(5.26±0.78)mmol/L vs(6.86±1.09)mmol/L,TG(1.58±0.45)mmol/L vs(2.06±0.37)mmol/L,LDL-C(2.51±0.48)mmol/L vs(2.97±0.45)mmol/L(P<0.01);常规组治疗后以上指标降低不多,他汀组治疗后ADMA、TC、TG、LDL-C均低于常规组.结论 阿托伐他汀可能通过调节ACS患者血浆血脂水平,进而降低ADMA的生成.

Effect of atorvastatin on level of asymmetric dimethylarginine of patients with acute coronary syndrome

Objective To investigate the effect of atorvastatin on level of asymmetric dimethylarginine（ADMA） of patients with acute coronary syndrome and its significance.Methods 78 patients with acute coronary syndrome were divided into two groups at random,respectively atorvastatin therapy group and conventional therapy group,and 40 healthy subjects served as control group.The levels of TC,TG,LDL-C,HDL-C and ADMA were measured before and after treatment.Results ①The level of ADMA of the patients of AMI（1.09±0.36） μmol/L was higher than that of the patients of UAP（0.91±0.22） μmol/L（P〈0.01）,and the levels of ADMA of above two groups were higher than that of control group（0.57±0.12） μmol/L（P〈0.01）.②After treatment for four weeks,the levels of ADMA,TC,TG and LDL-C in atorvastatin therapy group were all significantly lower than those before treatment,ADMA（0.67±0.25） μmol/L vs（1.02±0.32） μmol/L,TC（5.26±0.78） mmol/L vs（6.86±1.09） mmol/L,TG（1.58±0.45） mmol/L vs（2.06±0.37） mmol/L,LDL-C（2.51±0.48） mmol/L vs（2.97±0.45） mmol/L（P〈0.01）.The levels of above indexes were not decreased significantly in conventional therapy group after treament,and the levels of ADMA,TC,TG and LDL-C in atorvastatin therapy group were all lower than those in conventional therapy group after treatment.Conclusion Atorvastatin can decrease the level of ADMA of patients with acute coronary syndrome by regulating serum lipid proteins.