阿托伐他丁对心脏X综合征患者hs_CRP水平的影响_叶广宁

阿托伐他丁对心脏X综合征患者hs-CRP水平的影响

叶广宁1,钱招昕2,陈玉梅2

(1.广东省阳江市人民医院心内科,广东　阳江　529500;2.中南大学湘雅医院心内科)

【摘要】　目的　观察心脏X综合征病人血循环中高敏C反应蛋白的变化以及阿托伐他丁的可能影响。方法　选取25例心脏X综合征病人和10例健康人。⑴比较心脏X综合征病人和健康人血清hs-CRP水平;⑵比较胸痛频率每周≥5次(n=14)和<5次(n=11)两组心脏X综合征病人血清hs-CRP的水平;⑶比较胸痛持续时间≥15min(n=13)和<15min(n=12)两组血清hs-CRP的水平;⑷25例病人分为对照组(n=12,予以消心痛10mg Tid和地尔硫卓30mg Tid)和治疗组(n=13,在前者基础上加阿托伐他丁20mg QD),持续12周,比较两组胸痛症状和hs-CRP的变化。结果　⑴心脏X综合征病人血清hs-CRP显著高于健康人[(3.7±3.2mg/L vs0.9±0.5mg/L,P<0.01)];⑵胸痛频率每周≥5次组血清hs-CRP高于<5次组[(3.8±2.4mg/L vs2.6±2.6mg/ L,P<0.05)];⑶胸痛持续时间≥15min组血清hs-CRP高于<15min组[(3.9±3.0mg/L vs2.7±1.7mg/L,P<0.01)];⑷阿托伐他丁治疗组血清hs-CRP下降较对照组显著[(1.3±1.6mg/L vs2.8±3.1mg/L,P<0.01)],胸痛症状缓解更明显。结论　⑴hs-CRP 可能与心脏X综合征的发病相关;⑵阿托伐他丁有助于降低心脏X综合征病人的hs-CRP水平并缓解症状。

[关键词]　　高敏C反应蛋白;心脏X综合征;阿托伐他丁

The Effect of Atorvastatin on Seumr Hypersensitive C-reactive Protein Level in Patients with Cardiac Syndro me X

YE Guang-ning,QIA N Zhao-xin,CH EN Y u-mei.Department of Cardiology,The People's Hospital of Yangjiang City,Yangjiang529500, China

【Abstract】　Objective　To explore the level chan ges of serum hypersens itive C-reactive protein(hs-CRP)in patients with cardiac syn-drome X(CSX)and the effect of atorvastatin on hs-CRP level.Methods　25patients with CSX and10matched healthy subjects were enrolled in this study,and the serum hs-CRP levels were compared between the patients and healthy subjects.The patients were randomly devidid into routine therapy group(n=12),which received diltiazem30mg t.i.d and isorbide dinitrate10mg t.i.d,and atovastatin thrapy group(n=13),which received the same dosage of diltiazem and isobide dinitrate,and atovastatin20mg/d additionall y.The course of treatment was12weeks.At the be-ginning and the end of study,standardized an gina questionnaires and exercise stress test were performed in all patients,and their serum hs-CRP levels were measured.Results　⑴The seru m hs-CRP levels of patients with CSX were significantly hagher than those of health y subjects(3.7±3.2mg/L vs0.9±0.5mg/L,P<0.01);⑵The seru m hs-CRP levels of patients with frequent chest pain(≥5episodes/week)were higher than those of patients with less frequent chest pain(<5episodes/week)(3.8±2.4mg/L vs2.6±2.6mg/L,P<0.05);⑶The serum hs-CRP levels of patients with long duration chest pain(≥15min/epis ode)were higher than those of patients with short duration chest pain(<15min/episode) (3.9±3.0mg/L vs2.7±1.7mg/L,P<0.01);⑷The serum hs-CRP levels of patients in atovastatin thrapy group were significantly lower than those of patients in routine therap y group(1.3±1.6mg/L vs2.8±3.1mg/L,P<0.01),and symptoms of chest pain in atorvastatin therap y group were improved more obviously compared with routine therapy group.C onclussions　The hs-CRP might correlate with the pathogenesis of CSX.A-tovastatin might be useful to decrease the serum hs-CRP level and to alleviate the symptom of chest pain in the patients with CSX.

【Key words】　　Hypersensitive C-reactive protein;Cardiac s yndrome X;Atorvastatin

　　心脏X综合征病人有较典型的胸痛症状和缺血性心电图改变,而冠状动脉造影不能发现有意义狭窄病变[1]。其发病机制迄今仍不完全清楚,目前认为可能为心脏微血管的病变造成冠状动脉血流储备功能减退所致,有研究显示冠状动脉内皮功能受损可能参与了心脏X综合征的发病[2,3]。C反应蛋白作为一种全身炎性反应的标志物,已被证实与冠状动脉内皮功能不全相关,而他丁类药物在近年的许多研究中被证实在调脂之外另有抑制冠状动脉炎性反应的作用。本研究拟观察心脏X综合征病人血循环中高敏C反应蛋白(hs-CRP)的变化以及阿托伐他丁的可能影响。1　资料和方法

1·1　一般资料　选取我院2002-01～2003-08间经冠状动脉造影、常规心电图和运动平板心电图检查诊断为心脏X综合征的病人共25例,其中男性6例,女性19例,年龄41～62(平均52±7)岁。排除高血压、糖尿病。另选取了10例(2例男性,8例女性)健康体检者,年龄(53±4)岁。

1·2　分组与治疗　⑴将25例病人作为病人组,10例健康人为对照组,比较两组hs-CRP的区别;⑵根据胸痛发作频率将病人分成每周≥5次和<5次两组,比较两组血清hs-CRP的水平;⑶根据每次胸痛持续时间

1212Journal of Chinese Physician,September,2004,Vol6,No9

分为≥15min和<15min两组,比较两组血清hs-CRP 的水平;⑷将25例病人随机分为对照组和治疗组,前者予以消心痛10mg Tid和地尔硫卓30mg Tid治疗,后者在此基础上加用阿托伐他丁20mg QD,疗程12周,比较治疗前后血清hs-CRP变化,同时观察胸痛发作频率、最长持续时间、心电图ST段压低程度变化。同时在治疗前后测定血脂。

1·3　检测方法　⑴hs-CRP的测定采用胶乳增强免疫(超敏)比浊法,试剂盒购于上海申索公司。⑵ST段压低程度以运动平板心电图V1-6六个胸导联ST断压低值的平均值计算。

1·4　统计学处理　 …… 此处隐藏：7124字，全部文档内容请下载后查看。喜欢就下载吧 ……