Li Jian-Jun, Fang Chun-Hong, Qian Hai-Yan, Hu Wen-Lan
Renmin Hospital, Wuhan University School of Medicine, Wuhan, P.R. China.
Angiology. 2006 Jan-Feb;57(1):1-7. doi: 10.1177/000331970605700101.
The evidence has indicated that rapid reduction of inflammatory marker, such as C-reactive protein (CRP) could be achieved by administration of a statin. However, limited information is available in evaluating the short-term time course of CRP reduction in patients with coronary artery disease by use of a statin. Forty-two patients with stable angina were randomly assigned to 20 mg/d or 40 mg/d group of pravastatin. Blood samples were drawn at days 0, 1, and 14 for measuring lipid profile, CRP levels, and hepatic enzymes in all patients. The results showed that both doses of pravastatin induced significant reductions in median CRP levels and in mean CRP levels, respectively, at day 1 (20% in the 20 mg/d group and 17.6% in the 40 mg/d group; 15% in the 20 mg/d group and 10% in the 40 mg/d group) as well as at day 14 (28.6% in the 20 mg/d group and 33.3% in the 40 mg/d group; 25% in the 20 mg/d group and 22.8% in the 40 mg/d group) compared with baseline data without a dose-dependent manner. In addition, no changes were found at day 1 regarding lipid profile; however, both doses of pravastatin induced significant reductions in total cholesterol (TC, 22% and 30%), and low-density lipoprotein (LDL) cholesterol (30% and 40%) compared with baseline at 14 days. The higher dose of pravastatin resulted in significantly greater reductions in TC and LDL cholesterol compared with the 20 mg/d dose (p = 0.05, p = 0.01, respectively). A less significant reduction was observed in triglycerides level (16% and 24%) compared with TC and LDL cholesterol. There was no significant difference in mean high-density lipoprotein (HDL) cholesterol levels compared with baseline in both groups. These data suggested that a common daily dose of pravastatin resulted in rapid reduction of CRP within 24 hours and of lipid profile within 2 weeks, and the benefit to the vascular endothelium might occur quickly by reduction of CRP levels, which may be clinically important for patients in a high-risk subgroup, such as acute coronary artery disease.
有证据表明，使用他汀类药物可使炎症标志物如C反应蛋白（CRP）迅速降低。然而，关于使用他汀类药物降低冠心病患者CRP的短期时间进程，目前可用信息有限。42例稳定型心绞痛患者被随机分为普伐他汀20mg/d组或40mg/d组。在第0、1和14天采集所有患者的血样，以检测血脂、CRP水平和肝酶。结果显示，两种剂量的普伐他汀在第1天（20mg/d组为20%，40mg/d组为17.6%；20mg/d组为15%，40mg/d组为10%）以及第14天（20mg/d组为28.6%，40mg/d组为33.3%；20mg/d组为25%，40mg/d组为22.8%）均分别导致中位数CRP水平和平均CRP水平显著降低，且无剂量依赖性。此外，第1天时血脂无变化；然而，与基线相比，两种剂量的普伐他汀在第14天时均使总胆固醇（TC，分别降低22%和30%）和低密度脂蛋白（LDL）胆固醇（分别降低30%和40%）显著降低。与20mg/d剂量相比，较高剂量的普伐他汀使TC和LDL胆固醇降低幅度显著更大（分别为p = 0.05，p = 0.01）。与TC和LDL胆固醇相比，甘油三酯水平降低幅度较小（分别为16%和24%）。两组平均高密度脂蛋白（HDL）胆固醇水平与基线相比无显著差异。这些数据表明，普伐他汀的常用日剂量可在24小时内使CRP迅速降低，并在2周内使血脂降低，降低CRP水平可能会迅速对血管内皮产生益处，这对于高危亚组患者如急性冠状动脉疾病患者可能具有重要临床意义。
