不同剂量辛伐他汀早期干预对非ST抬高型急性冠脉综合征sCD40L水平的影响

目的：探讨不同剂量辛伐他汀早期干预治疗对非ST抬高型急性冠脉综合征患者sCD40L水平的影响。方法：60例非ST抬高型急性冠脉综合征患者随机分为3组：A组为常规治疗组（20例）予以常规治疗但不用降脂药物；B组（20例）为20mg辛伐他汀治疗组；C组为40mg辛伐他汀治疗组（20例）；20例稳定性心绞痛患者为对照组。60例非ST抬高型急性冠脉综合征患者在治疗2周前后分别测定血清sCD40L及血脂水平。结果：60例非ST抬高型急性冠脉综合征患者的血清sCD40L水平明显高于稳定性冠心病患者（P＜0．05），B、C组治疗2周后血清sCD40L平均有明显下降（P〈0.05），而以C组作用更明显。结论：非ST抬高型急性冠脉综合征患者血清sCD40L水平增高，早期辛伐他汀治疗可降低非ST抬高型急性冠脉综合征患者的血清sCD40L水平，且呈剂量依赖性。早期他汀类药物强化治疗可能使非ST抬高型急性冠脉综合征患者获益更大。

Effect of early simvastatin therapy on sCD40L in acute coronary syndrome with non-ST-segment elevation

Objective To investigate the effects of different doses of simvastatin on serum levels of sCD40L in the early phase of acute coronary syndrome with non-ST-segment elevation.Methods Sixty patients with acute coronary syndrome with non-ST-segment elevation were randomly separated into three groups.Twenty patients in group A were given routine therapy,20 patients in group B were given routine therapy and 20 mg simvastatin once daily for 2 weeks,and 20 patients in group C were given routine therapy and 40 mg simvastatin once daily for 2 weeks.Twenty patients with stable angina served controls.The serum levels of sCD40L before and after therapy were measured with ELISA method. Results The serum levels of sCD40L in the patients with acute coronary syndrome with non-ST-segment elevation were significantly higher than those in control group(P<0.05).The serum levels of sCD40L were significantly lowered after two weeks of therapy in group B and C(P<0.05 in all),especially in group C,while no significant difference was observed before and after treatment in group A.Conclusion The serum levels of sCD40L is increased in the patients with acute coronary syndrome with non-ST-segment elevation and early simvastatin intervention may decrease dose-dependently the serum levels of sCD40L.Early intensive simvastatin treatment may yield more significant benefits in the patients with acute coronary syndrome with non-ST-segment elevation.