瑞舒伐他汀对急性冠状动脉综合征伴高脂血症患者血脂及炎性因子的影响

目的 观察瑞舒伐他汀治疗急性冠状动脉综合征(ACS)伴高脂血症的I临床疗效及安全性.方法 2010年9月至2011年1月就诊于北京安贞医院心内科的ACS伴高脂血症患者90例,完全随机分为辛伐他汀组(药物使用量:10 mg/d,n=42)和瑞舒伐他汀组(药物使用量:10 mg/d,n=48),疗程均为1周,观察治疗前后各项主要血脂指标变化率、达标率及血清肿瘤坏死因子仪(TNF-a)及C反应蛋白(CRP)变化.结果 在降低TC、LDL-C、脂蛋白(Lp)(a)及升高HDL-C方面,瑞舒伐他汀组优于辛伐他汀组[TC:瑞舒伐他汀组治疗后(4.80±0.36)mmol/L、治疗前(6.80±0.27)mmol/L、变化率-29%,辛伐他汀组分别为(5.50±0.19)mmoL/L、(6.90±0.21)mmol/L、-21%;LDL-C:瑞舒伐他汀组治疗后(2.00±0.26)mmol/L、治疗前(4.50±0.10)mmol/L、变化率-56%,辛伐他汀组(3.30±0.27)mmol/L、(4.00±0.21)mmol/L、-18%;Lp(a):瑞舒伐他汀组治疗后(72±15)mmol/L、治疗前(115±21)mmol/L、变化率一37%,辛伐他汀组(101±24)mmol/L、(108±21)mmoL/L、-6%;HDL-C:瑞舒伐他汀组治疗后(0.98±0.05)mmol/L、治疗前(0.72±0.04)mmol/L、变化率+36%,辛伐他汀组(0.90±0.02)mmol/L、(0.80±0.05)mmoL/L、+13%].2组对肝、肾功能的影响差异无统计学意义.舒伐他汀治疗组降低炎症标志物TNF-a和CRP水平强于辛伐他汀组[TNF-a:瑞舒伐他汀组治疗后(62+20)U/ml、治疗前(90±10)U/ml、变化率-31%,辛伐他汀组分别为(71±15)U/ml、(86±13)U/ml、-17%;CRP:瑞舒伐他汀组治疗后(2.7+1.6)mg/L、治疗前(4.8±1.8)mg/L、变化率-44%,辛伐他汀组(4.0±1.3)ms/L、(5.2±1.5)ms/L、-23%].2组患者治疗期间未出现明显的、难以耐受的不良反应.结论 瑞舒伐他汀(10 mg/d)可以更全面地调理ACS伴混合性高脂血症患者的血脂异常,尤其是在升高HDL-C、降低LDL-C方面,并具有良好的安全性.瑞舒伐他汀具有较强抗炎作用.

Abstract：

Objective To investigate the effects and the safety of rosuvastiatin in actute coronary syndrome (ACS)complicated with hyperlipidemia.Methods Ninety patients with hyperlipidernia were randomly assigned into simvastatin group (n=42) and rosuvastatin group(n=48).They were treated with simvasmtin and rosuvastatin respeetively 10 mg/d and 10 mg/d for 1 week.Lipid profile and physical laboratory investigations for adverse effects were also assessed.Serum levels of total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol(HDL-C)and Lp(a)were measured at the end of 1 weeks of the trial period. Results Rosuvastatin treatment was more effective than simvastatin in reducing serunl levels of TC,LDL-C and Lp(a)and in raising HDL-C.The difference of liver and kidney function of 2 groups was not statistically significant.The abilities of atorvastatin treatment group in decreasing inflammatory markers in TNF-a and CRP levels were stronger than those in the simvastatin group.Conclusion Rosuvastatin has full-scale lipid-regulating effects,especially in reducing serum levels of TC,LDL-C and Lp(a) and in raising HDL-C.

Comparative study of the efficacy and safety of rosuvastatin in paients with acute coronary syndrome combined with hyperlipidemia

Objective To investigate the effects and the safety of rosuvastiatin in actute coronary syndrome (ACS)complicated with hyperlipidemia.Methods Ninety patients with hyperlipidernia were randomly assigned into simvastatin group (n=42) and rosuvastatin group(n=48).They were treated with simvasmtin and rosuvastatin respeetively 10 mg/d and 10 mg/d for 1 week.Lipid profile and physical laboratory investigations for adverse effects were also assessed.Serum levels of total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol(HDL-C)and Lp(a)were measured at the end of 1 weeks of the trial period. Results Rosuvastatin treatment was more effective than simvastatin in reducing serunl levels of TC,LDL-C and Lp(a)and in raising HDL-C.The difference of liver and kidney function of 2 groups was not statistically significant.The abilities of atorvastatin treatment group in decreasing inflammatory markers in TNF-a and CRP levels were stronger than those in the simvastatin group.Conclusion Rosuvastatin has full-scale lipid-regulating effects,especially in reducing serum levels of TC,LDL-C and Lp(a) and in raising HDL-C.