早期应用阿托伐他汀对正常血脂水平急性冠状动脉综合征患者炎症因子干预的观察

目的观察血脂正常的急性冠状动脉综合征(ACS)患者早期白介素-6(IL-6)和高敏C反应蛋白(hs-CRP)水平变化及阿托伐他汀早期治疗对其干预效果。方法将血脂水平正常的ACS患者随机分为阿托伐他汀治疗组(10mg/d×4周)和常规治疗组(各40例),另选择同期健康人40例作为健康对照组。分析比较组间及两组ACS患者治疗前、后血清IL-6和hs-CRP水平变化。结果两组ACS患者血脂水平与健康对照组比较差别无统计学意义,但其IL-6和hs-CRP水平均显著高于健康对照组(P<0.01);阿托伐他汀治疗2周时血脂水平无显著变化,但IL-6和hs-CRP水平显著降低(P<0.01),治疗4周时血清总胆固醇和低密度脂蛋白胆固醇及IL-6、hs-CRP水平均显著降低(P<0.05)且显著低于常规对照组(P<0.05)。结论血脂水平正常的ACS患者同样存在明显的炎症反应。阿托伐他汀具有独立于调脂的抗炎作用,其快速抗炎作用在ACS患者早期治疗中可能具有重要意义。

Effect of early atorvastatin on inflammatory factors in patients with acute coronary syndrome and normal lipidemia

Objective To study the effect of early atorvastatin on serum interleukin 6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP)in patients with acute coronary syndrome and normal lipid level. Methods 80 patients of ACS with normal lipid level were divided into routine controlled group (n=40) treated with conventional drugs and atorvastatin group (n=40) treated with atorvastatin 10mg per day within 48 hours from symptom onset. 40 healthy subjects were selected as normal controlled group. The level of IL-6 and hs-CRP were measured before and after 2 and 4 weeks treatment. Results The lipid level in two ACS groups were similar to normal controlled group, but IL-6 and hs-CRP level increased significantly(P<0.01=. After two weeks treatment with atorvastatin, the lipid level were not significant changed, but IL-6 and hs-CRP decreased significantly(P<0.01=. After four weeks treatment with atorvastatin, the total cholesterol, low density lipoprotein cholesterol, IL-6 and hs-CRP were all lowered significantly (P<0.05=. Conclusion The inflammatory may exist in patients of ACS with normal lipid level. Atorvastatin possess anti-inflammatory effect which independent of its lipid lowering action, and the rapid anti-inflammatory effect of atorvastatin might play an important role in the early treatment of ACS with normal lipid level.