阿托伐他汀早期干预对不稳定型心绞痛患者hs-CRP水平的影响

目的探讨不稳定型心绞痛(UA)与炎症指标高敏C反应蛋白(hs-CRP)的关系以及早期阿托伐他汀干预对UA患者血清hs-CRP水平的影响。方法采用颗粒增强免疫透射比浊法测定60例UA患者、53例稳定型心绞痛患者(SA组)以及50例健康对照者(对照组)的血清hs-CRP水平。采用随机开放法将UA组分成常规组和阿托伐他汀组进行为期4周的干预,比较治疗前后的血清hs-CRP及血脂水平变化。选择性冠状动脉造影采用Judkin’s法,共有78例患者和29例健康对照者完成造影。结果UA组血清hs-CRP基础水平明显高于SA组及对照组(P<0.01)。血清hs-CRP水平与依照Gensini积分评估的冠状动脉病变严重程度显著相关。UA患者治疗4周后,阿托伐他汀组血清hs-CRP及LDL-C水平均明显下降(P<0.01),而常规组无明显变化。相关分析显示,阿托伐他汀组血清hs-CRP水平的下降与LDL-C下降无相关性。结论UA的发生与机体炎症反应激活有关。血清hs-CRP水平与冠状动脉病变范围及程度有一定关系。阿托伐他汀快速降低血清hs-CRP水平,在UA的早期治疗中具有重要意义。

Effect of Serum High Sensitive C-reactive Protein Levels in Patients with Unstable Angina and Early Intervention with Atovastatin

Objective To explore the relations between UA and serum hs-CRP, the effects of early intervention with atovastatin on serum hs-CRP in patients with UA and its clinical significance in the early management of UA. Methods T 60 patients with UA (UA group),53 patients with stable angina (SA group) and 50 healthy controls (control group) were enrolled to the study. The serum hs-CRP levels were measured by particle enhanced immunoturbidimetric assay. UA group were randomly assigned to the atovastatin group and the routine group for a 4-week treatment immediately after admission. Selected coronary artery angiography was performed in 78 patients and 29 healthy controls with Judkin's technique. Results Baseline of hs-CRP in patients with UA was significantly higher than those in SA group and control group ( P <0.01). Serum hs-CRP levels were significantly associated with the severity of coronary atherosclerosis as determined by Gensini score. After 4 weeks of treatment, there were significant decrease in hs-CRP and LDL-C( P <0.01) levels in the atovastatin group. No relationships were observed between the decrease in hs-CRP and the decrease in LDL-C by correlation analysis in atovastatin group. Conclusion The occurrence of UA is related to aggravated systemic inflammation. Serum hs-CRP is related to the severity and extension of coronary artery. Atovastatin treatment rapidly decreases hs-CRP in patients with UA. This effect of atovastatin may play an important role in the early management with UA.