【摘要】 目的观察不同剂量瑞舒伐他汀治疗对急性冠状动脉综合征(acute coronary syndrome,ACS)患者血清高半胱氨酸(homocysteine,Hcy)、高敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)浓度变化与预后的影响。方法选取湛江中心人民医院住院的ACS患者112例,根据瑞舒伐他汀治疗剂量不同分为大剂量组56例,瑞舒伐他汀20 mg/d;常规剂量组56例,瑞舒伐他汀10 mg/d。两组治疗疗程均为1年。比较两组第1天、8天、15天、30天、60天血清Hcy、hs-CRP浓度以及总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、LDL-C浓度的差异;随访1年后比较两组颈动脉内膜中层厚度(CAIMT)的变化及主要心血管事件(MACE)发生率差异;分析Hcy、hs-CRP与MACE发生率的相关性。结果大剂量组血清Hcy、hs-CRP浓度较常规剂量组显著降低,差异有统计意义(P<0.01);血清总胆固醇及LDL-C浓度也显著降低,差异有统计意义(P<0.05);而血清高密度脂蛋白胆固醇浓度显著增高,差异有统计意义(P<0.05)。大剂量组的颈动脉内膜中层厚度较常规剂量组显著下降,差异有统计意义(P<0.05);主要心血管事件发生率显著低于常规剂量组,差异有统计意义(P<0.05);且不良反应发生率与常规剂量组比较,差异无统计学意义(P>0.05)。结论大剂量瑞舒伐他汀长期服用能显著降低ACS患者的血清炎症因子,减少主要心血管事件发生。更多还原

【Abstract】 Objectives To observe the influence of different doses of rosuvastatin on serum concentrations of homocysteine(Hcy), high-sensitivity C-reactive protein(hs-CRP) and low-density lipoprotein cholesterol(LDL-C)and prognosis in patients with acute coronary syndrome(ACS). Methods A total of 112 patients with ACS were enrolled and divided into high-dose group(n=56) :rosuvastatin 20 mg / d; and routine-dose group(n=56) : rosuvastatin10 mg / d. All the patients of the two groups received 1-year therapy. Serum concentrations of Hcy,hs-CRP, total cholesterol(TC), high-density lipoprotein cholesterol(HDL-C) and LDL-C were compared between the two groups on day 1, 8, 15, 30 and 60. By following up for one year, carotid artery intima-media thickness(CAIMT) and incidence of major adverse cardiac events(MACE) were compared between the two groups. Relationships of Hcy, hs-CRP and MACE were analyzed. Results Serum concentrations of Hcy and hs-CRP in high-dose group were significantly lower than those in routine-dose group(P <0.01), and serum concentrations of TC and LDL-C were lower than those in routine-dose group(P<0.05), while serum concentration of HDL-C was higher than that in routine-dose group(P <0.05). Compared with routine-dose group, CAIMT decreased remarkably and incidence of MACE was significantly lower in high-dose group(P<0.05). There was no significant difference in incidence of adverse reactions between the two groups(P >0.05). Conclusions Long-term use of high-dose rosuvastatin can significantly reduce serum concentrations of inflammatory factors in patients with ACS, which also reduces MACE.更多还原