不同剂量阿托伐他汀对急性冠脉综合征患者体内炎症反应、血小板活性及纤溶活性的影响

目的观察不同剂量阿托伐他汀对急性冠脉综合征(ACS)患者外周血中总胆固醇(TC)、高敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、血栓素B2(TXB2)、血小板颗粒膜蛋白-140(GMP-140)、血浆纤溶酶原激活剂抑制物-1(PAI-1)水平及血浆组织型纤溶酶原激活剂(t-PA)活性的影响。探讨阿托伐他汀对ACS防治的可能机制及不同剂量阿托伐他汀的安全性。方法ACS患者65例,在拜阿斯匹林、氯吡格雷等基础治疗外随机分为三组,分别给予阿托伐他汀10mg/d、20mg/d、40mg/d睡前服用。入院第1天、第14天分别抽取空腹静脉血16ml。测定hs-CRP、IL-6、TXB2、GMP-140、t-PA、PAI-1及TC、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、肌酸激酶(CK)。采用SPSS13.0统计软件对检测结果的组间及治疗前后进行比较。结果三组TC、hs-CRP、IL-6、TXB2、GMP-140、PAI-1治疗后均有下降、t-PA活性上升,治疗后三组间比较亦有差异;而三组治疗前后CK、ALT、AST组间无显著差异,治疗后无显著上升,以上结果均有统计学意义。结论阿托伐他汀对ACS患者血脂及炎症反应、血小板活性、纤溶活性有积极作用,并在一定范围内随着剂量的增加而加强,同时具有良好的安全性。

Effects of different Dosage of Atorvastatin on Inflammatory Response, Platelet Activity and Fibrinolytic Activity of Patients with Acute Coronary Syndrome

Objective To investigate the effect of different dosage of Atorvastatin on the TC, hs-CRP IL-6, TXB2, GMP-140, PAI-1 level and t-PA activity in peripheral blood of patitentes with ACS to search the mechanism and safety of aggressive lipid lowering treatment by Atorvastatin on prevention and treatment on ACS. Methods 65 cases of ACS patients were given 10mg/d, 20mg/d, 40mg/d Atorvastatin before sleeping besides routine treatments of asprine and clopidogrel. On the first day and 14th day, 16ml venous blood was taken, hs-CRP, IL-6, TXB2, GMP-140, t-PA, PAl-l, TC and AST, ALT, CK were measured. SPSS 13.0 statistical software was used to compare the data of pre-treatment and after-treatment. Results TC,hs-CRP, IL-6, TXB2, GMP-140, PAI-1 decreased significantly in all three groups, while t-PA activation increased remarkably. And after the treatment, there were significant differences among three groups on these items. But no visible statistics different of CK.AST.ALT among three groups.Conclnsions Atorvastatin perform active role to regulate blood lipod, inflammation response, platlet activity, fibrinolytic activity, and increase the function as the increase of dose in certain extension, and have good safety at the same time.