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目的探讨常规剂量阿托伐他汀对老年急性冠脉综合征(ACS)患者血清hs-CRP、sICAM-1和sCD40L的影响及意义。方法将老年ACS患者随机分3组:烟酸肌醇脂组、阿托伐他汀10 mg和20mg治疗组,每组20人。以20例老年健康体检者做为正常对照组。分别采用透射免疫比浊法及ELISA法测定这3组患者治疗前后及正常对照者血浆中hs-CRP、sICAM-1和sCD40L的水平。结果①用药前ACS组hs-CRP、sICAM-1和sCD40L的水平显著高于正常对照组,且具有统计学差异(P<0.05);②三个治疗组治疗4周后hs-CRP、sICAM-1和sCD40L水平比治疗前均显著下降,且具有统计学差异(P<0.05);③阿托伐他汀10 mg治疗组或20 mg治疗组的hs-CRP、sICAM-1和sCD40L下降程度均大于烟酸肌醇脂组,且具有统计学差异(P<0.05);④阿托伐他汀10 mg治疗组与20 mg治疗组的hs-CRP、sICAM-1和sCD40L下降程度无统计学差异(P>0.05)。结论阿托伐他汀10 mg治疗4周后可以显著降低血浆中炎症反应标志物hs-CRP、sICAM-1和sCD40L的浓度,与每天20 mg口服比较无显著性差异,具有可观的治疗价值。
Objective To investigate the effect and significance of routine dose of atorvastatin on serum hs-CRP, sICAM-1 and sCD40L in elderly patients with acute coronary syndrome (ACS). Methods Aged ACS patients were randomly divided into three groups: niacin inositol group, atorvastatin 10 mg and 20 mg treatment group, 20 in each group. Twenty elderly healthy people as normal control group. The plasma levels of hs-CRP, sICAM-1 and sCD40L in these 3 groups of patients before and after treatment and normal controls were measured by transmission immunonephelometry and ELISA respectively. Results ① The levels of hs-CRP, sICAM-1 and sCD40L in ACS group were significantly higher than those in normal control group before treatment (P <0.05); ②The levels of hs-CRP, sICAM- 1 and sCD40L decreased significantly compared with those before treatment (P <0.05); ③The levels of hs-CRP, sICAM-1 and sCD40L in atorvastatin 10 mg or 20 mg treatment group were significantly lower than those before treatment (P <0.05). (4) There was no significant difference in the levels of hs-CRP, sICAM-1 and sCD40L between atorvastatin 10 mg and 20 mg treatment groups (P > 0.05). Conclusion Atorvastatin 10 mg 4 weeks after treatment can significantly reduce plasma concentrations of inflammatory response markers hs-CRP, sICAM-1 and sCD40L 20 mg orally per day compared with no significant difference, with considerable therapeutic value.