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目的探讨初次服用不同剂量阿托伐他汀钙的冠心病患者血清胆红素水平变化,并将胆红素水平变化同C反应蛋白(CRP)、血尿酸进行相关性分析。方法回顾性分析心脏内科初诊冠心病患者276例,根据冠心病患者实际服用阿托伐他汀钙的剂量,分为20 mg/d组(158例)和40 mg/d组(118例)。收集服药前后临床资料,血清胆红素、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、CRP、血清尿酸水平进行对比分析,同时观察阿托伐他汀钙治疗1个月后上述指标的变化水平,并进行相关性分析。结果两不同剂量组服药后与服药前相比,血清总胆红素水平及直接胆红素水平均呈显著性升高(P<0.05),间接胆红素水平前后无明显差异。CRP水平与血清尿酸水平明显降低(P<0.05)。两不同剂量组间比较,40 mg/d组患者血清总胆红素[服药前:(10.3±2.0)μmol/L;服药后:(13.7±2.2)μmol/L]、直接胆红素[服药前:(3.0±1.1)μmol/L;服药后:(4.6±1.3)μmol/L]升高更显著(P<0.05),但间接胆红素水平未发生明显变化。同时40 mg/d组CRP及血清尿酸水平较20 mg/d组降低水平更明显(P<0.05)。直接胆红素变化与患者CRP、血清尿酸水平均呈负相关性。结论阿托伐他汀钙治疗冠心病可促使血清胆红素水平升高,同时降低CRP和血清尿素水平;且高剂量较低剂量作用更显著。血清胆红素水平的升高同CRP降低、血尿酸水平降低呈负相关。
Objective To investigate the changes of serum bilirubin levels in patients with coronary heart disease who received different doses of atorvastatin for the first time and to analyze the correlation between the levels of bilirubin and C-reactive protein (CRP) and serum uric acid. Methods A retrospective analysis of 276 cases of newly diagnosed coronary heart disease in cardiology was performed. The patients were divided into 20 mg / d group (n = 158) and 40 mg / d group (n = 118) according to the actual doses of atorvastatin calcium in patients with coronary heart disease. The clinical data, serum bilirubin, high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), CRP and serum uric acid levels were collected before and after taking the medicine for comparison. At the same time, atorvastatin calcium treatment 1 month after the above indicators of the level of change, and correlation analysis. Results Compared with pretreatment, the levels of total bilirubin and direct bilirubin in two different dosage groups were significantly increased (P <0.05), and there was no significant difference between before and after indirect bilirubin. CRP levels and serum uric acid levels were significantly lower (P <0.05). Serum total bilirubin in 40 mg / d group (before treatment: (10.3 ± 2.0) μmol / L; (13.7 ± 2.2) μmol / L after administration), direct bilirubin (3.0 ± 1.1) μmol / L before treatment and (4.6 ± 1.3) μmol / L after treatment) (P <0.05), but the level of indirect bilirubin did not change significantly. At the same time, CRP and serum uric acid levels in 40 mg / d group were significantly lower than those in 20 mg / d group (P <0.05). Changes in direct bilirubin and patients with CRP, serum uric acid levels were negatively correlated. Conclusion Atorvastatin calcium treatment of coronary heart disease can promote serum bilirubin levels, while reducing CRP and serum urea levels; and lower dose of higher doses of more significant. Serum bilirubin levels increased with CRP decreased serum uric acid levels was negatively correlated.