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目的探讨早期辛伐他汀对急性冠状动脉综合征(ACS)患者血清中高敏C反应蛋白(hs-CRP)和白细胞介素-6(IL-6)水平的影响。方法选择ACS患者70例,随机分为辛伐他汀组(36例):常规治疗组(34例);稳定型心绞痛(SAP)组30例。各组在入院时即检测血清中hs-CRP和IL-6水平。常规治疗组采用常规疗法(阿斯匹林、倍他乐克、ACE-I等)。辛伐他汀组在上述治疗基础上加用辛伐他汀20mg,每晚一次,连续应用4周。SAP组采用与辛伐他汀组同样的治疗方法。结果入院时两组ACS患者血清中hs-CRP和IL-6明显高于SAP组,两组间比较具有明显差异性(P<0.01),经治疗4周后,辛伐他汀组血清中hs-CRP和IL-6明显低于常规治疗组(P<0.01),而SAP治疗前后hs-CRP、IL-6无明显差异性。结论作为炎症反应的新标记物,在ACS的发生、发展中有重要的检测意义,早期应用辛伐他汀能有效降低ACS患者中的浓度,提高冠状动脉粥样斑块的稳定性,降低ACS的稳定性。
Objective To investigate the effect of early simvastatin on serum hs-CRP and IL-6 in patients with acute coronary syndrome (ACS). Methods Seventy patients with ACS were randomly divided into simvastatin group (n = 36), conventional treatment group (n = 34) and stable angina pectoris group (n = 30). Serum levels of hs-CRP and IL-6 were measured at admission in each group. The conventional treatment group used conventional therapies (aspirin, metoprolol, ACE-I, etc.). Simvastatin group on the basis of the above treatment with simvastatin 20mg, once night, for 4 weeks. The SAP group used the same treatment as the simvastatin group. Results Serum levels of hs-CRP and IL-6 in patients with ACS were significantly higher than those in SAP patients at admission (P <0.01). After 4 weeks of treatment, hs- CRP and IL-6 were significantly lower than those of the conventional treatment group (P <0.01), but there was no significant difference of hs-CRP and IL-6 before and after treatment with SAP. Conclusion As a new marker of inflammatory reaction, it has important significance in the occurrence and development of ACS. Early use of simvastatin can effectively reduce the concentration of ACS in patients with ACS, improve the stability of coronary atherosclerotic plaque and reduce the severity of ACS stability.