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目的分析不同剂量阿托伐他汀对冠心病合并高胆固醇血症患者超敏C反应蛋白(highsensitivity C-reactive protein,hs-CRP)及可溶性血管细胞粘附分子-1(soluble vascular cell adhesion molecule 1,sVCAM-1)的影响。方法选取2012年5月—2014年5月收治的100例冠心病合并高胆固醇血症患者,随机分为A组(阿托伐他汀,40mg/d,50例,其中不稳定心绞痛25例,急性心肌梗死25例)和B组(阿托伐他汀,10 mg/d,50例,其中不稳定心绞痛25例,急性心肌梗死25例)。2组患者均口服阿托伐他汀治疗12周,比较2组第4、12周血清中总胆固醇(total cholesterol,TC)、hs-CRP及sVCAM-1的水平。所有数据应用SPSS 18.0统计学软件进行分析。结果 2组患者治疗前TC、hs-CRP及sVCAM-1差异无统计学意义(P>0.05),心肌梗死患者hs-CRP及sVCAM-1水平显著高于不稳定心绞痛患者(P<0.05);治疗第4、12周2组患者血脂较治疗前明显下降,且A组显著低于B组(P<0.05),第12周下降更为显著(P<0.05);治疗第12周A组患者hs-CRP及sVCAM-1较治疗前显著下降(P<0.05),且第12周较第4周下降显著(P<0.05);各组在治疗过程中均无明显不良反应发生。结论大剂量阿托伐他汀长期治疗冠心病合并高胆固醇血症患者安全有效,降脂的同时降低炎症因子,稳定斑块。
Objective To investigate the effect of different doses of atorvastatin on the expression of hs-CRP and soluble vascular cell adhesion molecule-1 (Hs-CRP) in patients with coronary heart disease complicated with hypercholesterolemia, sVCAM-1). Methods A total of 100 patients with coronary heart disease complicated with hypercholesterolemia who were admitted to our hospital from May 2012 to May 2014 were randomly divided into group A (atorvastatin, 40mg / d, 50 cases, including 25 cases of unstable angina, acute 25 cases of myocardial infarction) and group B (atorvastatin, 10 mg / d, 50 cases, including unstable angina in 25 cases, 25 cases of acute myocardial infarction). Two groups of patients were treated with atorvastatin for 12 weeks. The levels of total cholesterol (TC), hs-CRP and sVCAM-1 in the two groups at 4 and 12 weeks were compared. All data were analyzed using SPSS 18.0 statistical software. Results The levels of hs-CRP and sVCAM-1 in patients with myocardial infarction were significantly higher than those in patients with unstable angina (P <0.05). There was no significant difference in TC, hs-CRP and sVCAM- Blood lipids in the two groups at 4 and 12 weeks after treatment were significantly lower than those before treatment, and the level of lipid in group A was significantly lower than that in group B (P <0.05) and decreased more significantly at week 12 (P <0.05) hs-CRP and sVCAM-1 decreased significantly compared with those before treatment (P <0.05), and decreased significantly in the 12th week compared with the 4th week (P <0.05). No adverse reactions occurred in the treatment groups. Conclusions Long-term treatment with high-dose atorvastatin is safe and effective in patients with coronary heart disease complicated with hypercholesterolemia, lipid-lowering while reducing inflammatory cytokines and stabilizing plaque.