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秋水仙碱可有效降低非 ST 段抬高型心肌梗死患者的炎症生物标志物高敏 C 反应蛋白(hs-CRP):一项随机、双盲、安慰剂对照临床试验。

Colchicine effectively attenuates inflammatory biomarker high-sensitivity C-reactive protein (hs-CRP) in patients with non-ST-segment elevation myocardial infarction: a randomised, double-blind, placebo-controlled clinical trial.

机构信息

Department of Cardiovascular Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Inflammopharmacology. 2021 Oct;29(5):1379-1387. doi: 10.1007/s10787-021-00865-0. Epub 2021 Aug 21.

Abstract

Myocardial infarction without ST-segment elevation (NSTEMI) is considered an inflammatory disorder associated with a high mortality rate worldwide. High-sensitivity C-reactive protein (hs-CRP) is an important inflammatory marker for NSTEMI and related to cardiovascular events. Colchicine, as a potent anti-inflammatory drug, is frequently prescribed for the treatment of gout and pericarditis. The present study aimed to evaluate the effects of colchicine, as an anti-inflammatory drug, on hs-CRP levels in NSTEMI patients. We performed a randomised, double-blind, placebo-controlled trial involving 150 NSTEMI patients referred to Imam Reza and Ghaem Hospitals affiliated to Mashhad University of Medical Sciences. The patients were randomised to receive colchicine or placebo along with optimal medications for 30 days. The hs-CRP was measured at the admission and end of the study. Our results revealed that, in both colchicine and placebo groups, hs-CRP levels were significantly mitigated in NSTEMI patients compared to baseline (P < 0.001). However, the decreasing properties of colchicine on hs-CRP levels were remarkably stronger than placebo following the 30 days of treatment (P < 0.001). Nevertheless, neither colchicine nor placebo treatment could achieve hs-CRP levels lower than 2 mg/L. There were no significant differences between the effects of colchicine on the hs-CRP decrease in diabetic and non-diabetic, male and female, and normal and preserved LVEF NSTEMI patients. It can be concluded that colchicine may prevent the disease progression and succedent cardiovascular events in NSTEMI patients by attenuating the inflammation.

摘要

无 ST 段抬高的心肌梗死(NSTEMI)被认为是一种与全球高死亡率相关的炎症性疾病。高敏 C 反应蛋白(hs-CRP)是 NSTEMI 的一个重要炎症标志物,与心血管事件相关。秋水仙碱作为一种有效的抗炎药物,常被用于治疗痛风和心包炎。本研究旨在评估秋水仙碱作为抗炎药物对 NSTEMI 患者 hs-CRP 水平的影响。我们进行了一项随机、双盲、安慰剂对照试验,纳入了 150 名来自马什哈德医科大学附属伊玛目礼萨和加姆医院的 NSTEMI 患者。患者被随机分为秋水仙碱组或安慰剂组,同时接受最佳药物治疗 30 天。在入院时和研究结束时测量 hs-CRP。我们的结果表明,与基线相比,秋水仙碱组和安慰剂组的 NSTEMI 患者的 hs-CRP 水平均显著降低(P<0.001)。然而,与安慰剂组相比,秋水仙碱组在治疗 30 天后对 hs-CRP 水平的降低作用更强(P<0.001)。然而,秋水仙碱和安慰剂治疗均未能使 hs-CRP 水平降至 2mg/L 以下。秋水仙碱对糖尿病和非糖尿病、男性和女性以及正常和保留左心室射血分数的 NSTEMI 患者的 hs-CRP 降低作用无显著差异。综上所述,秋水仙碱可能通过减轻炎症来预防 NSTEMI 患者的疾病进展和随后的心血管事件。

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