大剂量辛伐他汀对急性心肌梗死患者纤溶活性及C-反应蛋白的早期干预作用

目的 探讨辛伐他汀对急性心肌梗死（AMI）患者血清C-反应蛋白（CRP）水平及纤溶活性的影响。方法60例AMI患者随机分为常规治疗组（30例）和阿托伐他汀治疗组（30例），20例健康人为对照组。阿托伐他汀治疗组于常规治疗基础上加用辛伐他汀40g／d，疗程为4周。两组均于治疗前和治疗结束时测定血清CRP、血清总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白-胆固醇（HDL—C）、低密度脂蛋白-胆固醇（LDL—C）、组织型纤溶酶原激活物（t-PA）和纤溶酶原激活物抑制物-1（PAI-1）。结果辛伐他汀组治疗4周后，CRP、TC、TG、LDL—C、PAI-1较治疗前下降（P＜0．05或0．01）。常规组治疗前后无明显变化（P＞0．05）。治疗前AMI患者血清cRP与PAI-1活性呈正相关（r=0．393，P＜0．05），与t．PA呈负相关（r=-0．359，P＜0．01）。辛伐他汀组治疗后CRP、PAI-1、t—PA与TC、LDL-C水平变化无相关性。结论在AMI早期给予大剂量辛伐他汀治疗，可能有利于抑制炎症反应，稳定斑块，提高纤溶活性。

Early interventional effect of high-dose simvastatin on fibrinolytic activity and C-reactive protein in patients with acute myocardial infarction

Objective To study the effect of high-dose simvastatin on fibrinolytic activity and C-reactive protein (CRP) in patients with acute myocardial infarction (AMI).Methods 60 AMI cases were randomly divided into routine treatment group (n=30) and simvastatin treatment group (n=30) and 20 healthy subjects were taken as controls.Simvastatin treatment group took 40g/d simvastatin for 4 weeks in addition to routine therapy.CRP,serum total cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) levels were measured before and after treatment.Results After 4-week treatment,the levels of CRP,TC,TG,LDL-C,and PAI-1 of simvastatin treatment group were decreased (P<0.05 or 0.01),however,which were not changed significantly in routine group (P>0.05).Before treatment,CRP level of AMI patients was positively correlated with PAI-1 level(r=0.393,P<0.05) and negatively correlated with t-PA level(R=-0.359,P<0.01),while the simvastatin treatment group did not show any correlation of CRP,PAI-1 and t-PA levels with TC and LDL-C levels after treatment.Conclusion Early high-dose simvastatin treatment may be helpful to inhibit inflammatory responses,increase fibrinolytic activity and stabilize atherosclerotic plaque in AMI patients.