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目的研究大剂量(40 mg/d)和常规剂量(20 mg/d)辛伐他汀治疗急性冠脉综合征(ACS)2周后,对患者血浆高敏C反应蛋白(hs-CRP)水平的影响。方法选取ACS患者86例,随机分为常规剂量组(n=43,辛伐他汀20 mg/d)和大剂量组(n=43,辛伐他汀40 mg/d),测定治疗前和治疗1、2周后患者血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)和hs-CRP水平。结果治疗2周后,常规剂量组和大剂量组TG和HDL-C变化不明显,TC和LDL-C均下降(P<0.05),大剂量组下降更为明显;hs-CRP水平亦呈下降趋势,大剂量组下降更为明显(P<0.01)。相关性分析显示,治疗后血浆hs-CRP浓度的变化与同期血脂(TC、LDL-C、HDL-C、TG)水平的变化无显著相关性。结论短期大剂量辛伐他汀治疗可以使血脂和hs-CRP水平显著下降,减少炎症反应,稳定动脉粥样硬化斑块。
Objective To investigate the effects of simvastatin at high dose (40 mg / d) and conventional dose (20 mg / d) simvastatin on plasma levels of hs-CRP in patients with acute coronary syndrome (ACS) . Methods Eighty-six ACS patients were randomly divided into routine dose group (n = 43, simvastatin 20 mg / d) and high dose group (n = 43, simvastatin 40 mg / d) (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglyceride (TG) and hs-CRP levels in patients after 2 weeks. Results After two weeks of treatment, the levels of TG and HDL-C in the conventional and high-dose groups did not change significantly, while the levels of TC and LDL-C decreased (P <0.05). The levels of hs-CRP decreased significantly in the high-dose group Trend, high-dose group decreased more significantly (P <0.01). Correlation analysis showed that there was no significant correlation between changes of plasma hs-CRP level and changes of serum lipids (TC, LDL-C, HDL-C, TG) after treatment. Conclusion Short-term high-dose simvastatin treatment can significantly reduce the level of serum lipids and hs-CRP, reduce the inflammatory response and stabilize the atherosclerotic plaque.