The effects of different statin on blood lipid and inflammatory factors in coronary heart disease(CHD) patients
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摘要:
目的 对比经阿托伐他汀（立普妥20 mg）及瑞舒伐他汀（可定10 mg）治疗4 周后，冠心病患者LDL-C（低密度脂蛋白）、CX3CR1以及Hcy（同型半胱氨酸）水平的变化。 方 法选择经冠状动脉造影后确诊为冠心病的患者，其中80例稳定型心绞痛病例，80例不稳定型心绞痛病例，分别随机分为两组（A组和B组）；A组服用阿托伐他汀，B组服用瑞舒伐他汀。采用均相酶显色法检测LDL-C水平，利用流式细胞仪直接免疫荧光法检测不同类型患者外周血单核细胞上CX3CR1的表达，采用酶循环法检测Hcy水平。 结果经过4周的阿托伐他汀及瑞舒伐他汀治疗后各组冠心病患者LDL-C及Hcy水平较治疗前均有所下降（P＜0.05），CX3CR1在各组患者外周血单核细胞中的表达较治疗前均减低（P＜0.05），且治疗后LDL-C水平两组间比较有统计学差异（P＜0.05），但治疗后CX3CR1及Hcy水平无统计学差异。 结论阿托伐他汀及瑞舒伐他汀可有效降低血脂，同时具有抗炎作用；但瑞舒伐他汀的降脂效果要强于阿托伐他汀。 Abstract:ObjectiveTo observe the effect of atorvastatin and rosuvastatin on change of LDL-C, CX3CR1 and Hcy in coronary heart disease (CHD) patients after 4 weeks. Methods LDL-C were measured by the colorimetric method, the expression of CX3CR1 on monocytes were measured by direct immunofluorescence techniques associated with flow cytometer(FCM) and Hcy were measured by enzymatic cycling methods in 80 patients with stable angina pectoris(SAP) confimed by coronary arteriography, 80 patients with unstable angina pectoris(UAP). They Were randomly divided into two groups（A group and B group）, A group took atorvastatin and B group took rosuvastatin. ResultsCompared with the data before treatment, atorvastatin and rosuvastatin both decreased the level of LDL-C, CX3CR1 and Hcy at the 4th weak all of the CHD groups, and the differences were statistically significant (P＜0.05). And there was significant difference between the treatment groups (P＜ 0.05). ConclusionAtorvastatin and Rosuvastatin all can significantly decrease serum lipid level and have an anti-inflammatory effect.But rosuvastatin can higher strengthen the effects on decreasing lipids than atorvastatin. -
Key words:
- coronary heart disease /
- LDL-C /
- CX3CR1 /
- Hcy /
- statin /
- inflammation
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表 1 各组一般情况及冠心病危险因素比较
Table 1. Clinical data of the cases and controls（n=40）
组别 年龄 性别（女/男） 高血压 血糖异常 血脂异常 吸烟史 A组AUP组 60.950±4.750 16/24 11 10 40 25 A组SAP组 60.325±6.014 15/25 11 9 40 25 B组AUP组 61.400±5.358 16/24 12 9 40 26 B组SAP组 60.900±4.803 16/24 11 10 40 25 
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表 2 各组治疗前后LDL-C水平对比
Table 2. Changes of LDL-C in the four groups (Mean±SD)
时间 A组SAP组 A组UAP组 B组SAP组 B组UAP组 治疗前LDL-C水平（mmol/L） 3.934±0.425 4.125±0.491 3.934±0.425 4.125±0.491 治疗后LDL-C水平（mmol/L） 2.656±0.433a 2.935±0.333a 2.344±0.354ab 2.587±0.405ac aP＜0.05，各组与治疗前比较; bP＜0.05, 与A组SAP组治疗后比较; cP＜0.05，与A组UAP组治疗后比较.
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表 3 各组治疗前后CX3CR1水平对比
Table 3. Changes of CX3CR1 in the four groups (Mean±SD)
时间 A组SAP组 A组UAP组 B组SAP组 B组UAP组 治疗前CX3CR1 荧光强度（%） 15.725±2.590 26.498±3.594 15.725±2.590 26.498±3.594 治疗后CX3CR1 荧光强度（%） 7.106±1.844* 13.099±2.041* 6.913±1.434* 12.750±2.025* *P＜0.05，各组与治疗前比较.
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表 4 各组治疗前后HCY水平对比
Table 4. Changes of Hcy in the four groups (Mean±SD)
时间 A组SAP组 A组UAP组 B组SAP组 B组UAP组 治疗前Hcy水平（μmol/L） 5.61975±1.642 15.707±2.571 5.620±1.642 15.707±2.571 治疗后Hcy水平（μmol/L） 4.131±1.393* 13.482±2.365* 3.799±1.356* 13.166±2.396* *P＜0.05, 各组与治疗前比较.
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