辛伐他汀对急性冠脉综合征患者炎症因子水平影响的研究

目的观察辛伐他汀治疗75例急性冠脉综合征患者2周后血清血管内皮生长因子（VEGF）和血管细胞黏附分子-1（VCAM-1）等炎症因子水平的变化，以了解短期辛伐他汀治疗对斑块稳定性的影响。方法75例急性冠脉综合征患者随机分为常规治疗组（未服用辛伐他汀及任何调脂药物，30例）和辛伐他汀组（20mg／d，45例）治疗，测定治疗前后患者血清vEGF、VCAM-1和血脂水平的变化。结果辛伐他汀组治疗后血清VEGF和VCAM-1水平分别降低29．7％和21．7％，与治疗前比较差异有统计学意义（P〈0．05或P〈0．01）。两组治疗后血浆总胆固醇（TC）浓度均有显著下降（P〈0．01），但两组间下降程度比较差异无统计学意义；辛伐他汀组治疗后血浆LDL—C浓度显著下降21．0％（P〈20．01）。辛伐他汀组VEGF的下降百分数与VCAM-1的下降百分数之间有相关性（r=0．25，P〈0．05），与TC（r=0．12，P=0．33）、低密度脂蛋白（LDL—C）（r=0．08，P=0．52）的下降百分数之间无相关性。结论在急性冠状动脉综合征的早期予以2周辛伐他汀治疗，可明显降低血清炎症因子的水平，具有一定的增加斑块稳定性的作用。

Effect of Simvastatin on Serum Level of Inflammatory Factors in Acute Coronary Syndrome

Objective To observe the influence of simvastatin on serum level of vascular endothelial growth factor（VEGF）and vas cular cell adhesion molecule - 1（VCAM - 1）in patients （pts） with acute coronary syndrome. Methods Seventy - five pts with acute coronary syndrome were randomized to simvastatin group （20 mg/d, n = 45） and control group （without lipid - lowering drugs, n 30）. Levels of VEGF, VCAM - 1 and blood lipid before and after treatment were detected. Results After treatment, the levels of VEGF, VCAM - 1 and low - density lipoprotein cholesterol（LDL - C） in simvastatin group were significantly decreased at 29.7 %, 21.7 % and 21.0% ,respectively（P〈0.05 or P〈0.01）. There were significant relation between the decrease percent of VCAM - 1 and that of VEGF（r= 0.25, P〈0.05）, but there were no relations between the decrease percent of TC and LDL -C and that of VEGF（r= 0.12, P = 0.33;r= 0.08, P= 0.52）. Conclusion Simvastatin could decrease serum level of inflammatory factors in the pts with acute coronary syndrome within the first two weeks,so it might benefit to atherosclerotic plaque stabilization.