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目的探讨急性冠脉综合征患者使用不同剂量阿托伐他汀治疗2周对血清高敏C反应蛋白浓度的影响。方法连续入选2009年11月至2011年9月番禺中心医院收治的冠状动脉粥样硬化性心脏病(冠心病)患者126例,按电脑随机数字表法分为两组,每组63例,均给予抗凝、抗血小板聚集、血管紧张素转换酶抑制剂、β受体阻断药、硝酸酯类等药物治疗。小剂量组在常规治疗基础上给予口服阿托伐他汀20 mg/d;大剂量组在常规治疗基础上给予口服阿托伐他汀40 mg/d。所有患者在治疗前、治疗2周后分别测定血脂和血清高敏C反应蛋白(high sensitivety C reactive protein,hs-CRP)浓度,并进行比较分析。结果两组在治疗2周之后的血清总胆固醇、三酰甘油、低密度脂蛋白胆固醇及hs-CRP浓度与治疗前比较,均明显降低,差异有统计学意义(P<0.05);并且大剂量组血清总胆固醇[(4.42±0.62)mmol/L vs.(4.95±0.67)mmol/L,P<0.01]、三酰甘油[(1.02±0.19)mmol/L vs.(1.13±0.23)mmol/L,P<0.01]、低密度脂蛋白胆固醇[(2.55±0.46)mmol/L vs.(2.64±0.33)mmol/L,P<0.01]及hs-CRP[(9.66±1.48)mg/L vs.(10.59±3.32)mg/L,P<0.01]浓度降低幅度更大,与小剂量组治疗后比较,差异有统计学意义。结论阿托伐他汀能明显抑制急性冠脉综合征的炎性反应,降低血清hs-CRP浓度,并且治疗效果随剂量的增加而增强。
Objective To investigate the effect of different doses of atorvastatin on serum high-sensitivity C-reactive protein in patients with acute coronary syndrome. Methods A total of 126 patients with coronary atherosclerotic heart disease (CHD) who were admitted to Panyu Central Hospital from November 2009 to September 2011 were divided into two groups according to the computerized random number table method, with 63 cases in each group Given anticoagulant, anti-platelet aggregation, angiotensin-converting enzyme inhibitors, beta blockers, nitrates and other drug treatment. Small-dose group was given oral atorvastatin 20 mg / d on the basis of routine treatment; high-dose group was given oral atorvastatin 40 mg / d on the basis of routine treatment. All patients before treatment, after 2 weeks of treatment were measured serum lipid and serum high-sensitivity C-reactive protein (hs-CRP) concentrations, and comparative analysis. Results Serum total cholesterol, triglyceride, low density lipoprotein cholesterol, and hs-CRP levels in two groups after treatment for 2 weeks were significantly lower than those before treatment, with statistical significance (P <0.05); and high-dose Serum total cholesterol (4.42 ± 0.62 mmol / L vs. 4.95 ± 0.67 mmol / L, P <0.01) and triglyceride (1.02 ± 0.19 mmol / L vs. 1.13 ± 0.23 mmol / L, P <0.01], LDL cholesterol [(2.55 ± 0.46) mmol / L vs. (2.64 ± 0.33) mmol / L, P 0.01 and hs-CRP [(9.66 ± 1.48) mg / L vs (10.59 ± 3.32) mg / L, P <0.01], and the difference was statistically significant compared with the low dose group after treatment. Conclusions Atorvastatin can significantly inhibit the inflammatory response of acute coronary syndrome and decrease the concentration of serum hs-CRP, and the therapeutic effect increases with the increase of dose.