不同剂量阿托伐他汀对急性冠脉综合征患者高敏C反应蛋白的影响

目的探讨急性冠脉综合征患者使用不同剂量阿托伐他汀治疗2周对血清高敏C反应蛋白浓度的影响。方法连续入选2009年11月至2011年9月番禺中心医院收治的冠状动脉粥样硬化性心脏病（冠心病）患者126例，按电脑随机数字表法分为两组，每组63例。均给予抗凝、抗血小板聚集、血管紧张素转换酶抑制剂、p受体阻断药、硝酸酯类等药物治疗。小剂量组在常规治疗基础上给予口服阿托伐他汀20mg／d：大剂量组在常规治疗基础上给予1：3服阿托伐他汀40mg／d。所有患者在治疗前、治疗2周后分别测定血脂和血清高敏c反应蛋白（high sensitivety C reactive protein, hs-CRP）浓度，并进行比较分析。结果两组在治疗2周之后的血清总胆固醇、三酰甘油、低密度脂蛋白胆固醇及hs．CRP浓度与治疗前比较．均明显降低．差异有统计学意义（P〈0．05）；并且大剂量组血清总胆固醇（4．42±0．62）mmol／L孤（4．95±0．67）mmol／L，P〈0．01]、三酰甘油（1．02±0．19）mmol／L诋（1．13±O．23）mmol／L，P〈0．01]、低密度脂蛋白胆固醇（2．55±0．46）mmol／L／）S．（2．64±0．33）mmo｜／L，P〈0．01]及hs．CRP（9．66±1．48）mg／L眠（10．59±3．32）mg／L，P〈O．01]浓度降低幅度更大，与小剂量组治疗后比较，差异有统计学意义。结论阿托伐他汀能明显抑制急性冠脉综合征的炎性反应．降低血清hs-CRP浓度，并且治疗效果随剂量的增加而增强。

Effect of different doses of atorvastatin on high sensitivity C reactive protein in patients with acute coronary syndrome

Objectives To investigate the effect of taking different doses of atorvastatin for two weeks on high sensitivity C reactive protein(hs-CRP) in patients with acute coronary syndrome(ACS).Methods A total of 126 patients with coronary artery disease in Panyu Central Hospital from November 2009 to September 2011 were divided into two groups randomly and each group had 63 patients.All of them were given nitroglycerin,isosorbide dinitrate,enteric-coated aspirin,low molecular heparin as general therapy.Small dose group was added atorvastatin 20 mg/d to general therapy,and large dose group was added atorvastatin 40 mg/d to general therapy.Serum concentrations of hs-CRP and blood lipid of the patients were detected and comopared before and after two weeks of treatment.Results Serum concentrations of total cholesterol(TC),triacylglycerol(TG),low density lipoprotein cholesterol LDL-C and hs-CRP were decreased significantly after two weeks’ therapy in the two groups(P<0.05).Serum concentrations of TC (4.42±0.62) mmol/L vs.(4.95±0.67) mmol/L,P<0.01],TG (1.02±0.19) mmol/L vs.(1.13±0.23) mmol/L,P<0.01],LDL-C (2.55±0.46) mmol/L vs.(2.64±0.33) mmol/L,P<0.01] and hs-CRP (9.66±1.48) mg/L vs.(10.59±3.32) mg/L,P<0.01] decreased more significantly in large dose group.Conclusions Atorvastatin can significantly inhibit inflammation in ACS and decrease serum concentration of hs-CRP.The Effect can be enhanced with increasing dose of atorvastatin.