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冠心病患者使用大剂量阿托伐他汀进行短期治疗可减轻炎症反应。

Short-term therapy with high dose atorvastatin in patients with coronary artery disease can reduce inflammatory process.

作者信息

Nesar Hossein Vida, Yosef Nejad Keivan, Abdollahian Fatemeh

机构信息

Department of Internal Cardiology, Fatemeh Zahra Hospital of Sari, Mazandaran University of Medical Sciences, Mazandaran, Iran.

出版信息

Acta Med Iran. 2010 Jul-Aug;48(4):218-21.

Abstract

Coronary heart disease is the leading cause of death and disability in adults. The association between acute coronary syndrome (ACS) and elevated serum high sensitivity c-reactive protein (hsCRP) suggests that chronic inflammation of the coronary arterial wall may play an important role. A number of drugs used in the treatment of cardiovascular disease reduce serum CRP. It* is therefore possible that reduced inflammation contributes to the beneficial effects of these medications. This was a double blind randomized clinical trial on 52 patients were admitted because of ACS at the Mazandaran Heart Center, Iran in 2007. The patients were divided to three randomized groups which received 20, 40, 80* mg Atorvastatin daily for 6 months. At the time of study enrollment and 1, 3 and 6 months after initiation hsCRP were measured. 1 and 3 month after 20mg atorvastatin therapy the median serum concentration of hsCRP did not decrease significantly, but at the end of 6th month it was* significant difference. At 40 mg dosage from 3rd month to 6th month versus 1st month to 3rd month it was significant decrease, at the end of 1st month and 3rd month it was not significant. At 80 mg dose at the end of 1st month it was not significant but at the* end of 3rd month and end of 6th month it was significant. Intensive lipid-lowering therapy with high-dose atorvastatin therapy relative to moderate lipid-lowering therapy with low-dose atorvastatin reduces hsCRP better. We found that treatment with greater dose of atorvastatin might decrease greater in plasma level of hsCRP.

摘要

冠心病是成年人死亡和残疾的主要原因。急性冠状动脉综合征(ACS)与血清高敏C反应蛋白(hsCRP)升高之间的关联表明,冠状动脉壁的慢性炎症可能起重要作用。一些用于治疗心血管疾病的药物可降低血清CRP。因此,炎症减轻可能有助于这些药物产生有益效果。这是一项双盲随机临床试验,2007年在伊朗马赞德兰心脏中心,对52例因ACS入院的患者进行了研究。患者被随机分为三组,分别每日服用20、40、80毫克阿托伐他汀,为期6个月。在研究入组时以及开始治疗后的1、3和6个月测量hsCRP。服用20毫克阿托伐他汀治疗1个月和3个月后,hsCRP的血清中位数浓度没有显著下降,但在第6个月末有显著差异。服用40毫克剂量时,从第3个月到第6个月与第1个月到第3个月相比有显著下降,在第1个月末和第3个月末没有显著差异。服用80毫克剂量时,在第1个月末没有显著差异,但在第3个月末和第6个月末有显著差异。相对于低剂量阿托伐他汀的中度降脂治疗,高剂量阿托伐他汀的强化降脂治疗能更好地降低hsCRP。我们发现,使用更大剂量的阿托伐他汀治疗可能会使hsCRP的血浆水平下降得更多。

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