阿托伐他汀钙早期干预对不稳定性心绞痛患者sCD40L、超敏C反应蛋白水平的影响

目的观察不同剂量阿托伐他汀钙早期干预治疗对急性冠状动脉综合征(ACS)患者可溶性白细胞分化抗原40配体(sCD40L)、超敏C反应蛋白(hs-CRP)水平的影响,并探讨两者的相关性。方法将47例不稳定性心绞痛患者随机分为2组:A组(22例)给予阿托伐他汀钙10mg治疗;B组(25例)给予阿托伐他汀钙30mg治疗。另选20例稳定性心绞痛患者设为C组,给予常规治疗。3组治疗3周后分别测定血清sCD40L、hs-CRP及血脂水平。结果 47例不稳定性心绞痛患者的血清sCD40L、hs-CRP水平明显低于C组(P<0.05);A、B组治疗3周后血清sCD40L、hs-CRP水平有明显下降(P<0.05或P<0.01)。3组治疗前后血脂水平无变化(P>0.05)。3组治疗前后sCD40L、hs-CRP水平呈正相关(r治疗前=0.98,r治疗后=0.99)。结论早期阿托伐他汀钙治疗可降低不稳定性心绞痛患者的血清sCD40L、hs-CRP水平,且呈剂量依赖性。早期他汀类药物强化治疗可使不稳定性心绞痛患者获益更大。血清sCD40L、hs-CRP水平可成为预测冠心病不稳定斑块的参考指标之一。

Effect of early atorvastatin therapy on sCD40L,hs-CRP in unstable angina

Objective To investigate the effects of different doses of atorvastatin on serum levels of sCD40L,hs-CRP in patient with acute coronary syndrome,and analyse the correlation between sCD40L and hs-CRP.Methods 47 cases patients with unstable angina were randomly divided into two groups：Group A（22 cases）were given atorvastatin 10mg;Group B（25 cases）were given atorvastatin 30mg.And 20 cases patients with stable angina were as group C,were received conventional therapy.3 weeks after therapy,measured the serum levels of sCD40L,hs-CRP and lipid level of 3 groups.Results The levels of serum sCD40L,hs-CRP of 47 cases patients with unstable angina pectoris were significantly lower than that of group C（P0.05）;A,B group 3 weeks after treatment,the levels of serum sCD40L,hs-CRP of group A and B decreased significantly（P0.05 or P0.01）.The lipid level before and after treatment of 3 groups were no change（P0.05）.Before and after treatment,the levels of sCD40L,hs-CRP was positively correlated（rbefore=0.98,rafter=0.99）.Conclusion Early atorvastatin intervention can decrease the levels of serum sCD40L,hs-CRP of patient with unstable angina,and the high dose of atorvastatin may be better.Early intensive atorvastatin in treatment may yield more significant benefts in the patient with unstable angina.The level of serum sCD40L,hs-CRP may become a reference indicator of unstable plaque in coronary heart disease.