辛伐他汀对急性心肌梗死患者内皮功能和斑块稳定性的影响(1)
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【摘要】 目的 观察辛伐他汀对急性心肌梗死(AMI)患者血清高敏C-反应蛋白(hs-CRP)、内皮素-1(ET-1)、心肌肌酸激酶同功酶(CK-MB)的影响,探讨辛伐他汀在斑块稳定性和炎症反应中的作用。方法 选取AMI患者56例,按发病前是否因心绞痛、血脂异常服用过辛伐他汀分为治疗组25例,服用辛伐他汀(20 mg,1次/d)4周以上与对照组31例,未服用辛伐他汀。采用放射免疫法、酶联免疫吸附法检测2组患者血清hs-CRP、ET-1、CK-MB水平。结果 治疗组血浆hs-CRP、ET-1、CK-MB水平低于对照组,差异有统计学意义(P<0.05)。结论 辛伐他汀可抑制炎症反应,改善内皮功能,稳定粥样斑块,缩小心肌梗死范围。
【关键词】 辛伐他汀; 心肌梗死 ; C-反应蛋白 ; 内皮素-1
Effect of simvastatin on plaque stability and endothelial function in patients with acute myocardial infarction
LUO Gui-qin,LI Yan,XIE Zhong-min.Department of Cardiology,the Second People‘s Hospital,in Shizuishan City,Ningxia 753000,Shizhishan China
【Abstract】 Objective To explore the effects of simvastatin on plaque stability and inflammatory reaction by investigating the serum levels of high sensitive C-reactive protein(hsCRP),endothlin-1(ET-1)and creatine kinase-MB(CK-MB)in patients with acute myocardial infarction(AMI).Methods Fifty-six patients with AMI were divided into 2 groups:simvastatin treatment group(n=25):simvastatin was administrated more than 4 weeks before AMI,control group(n=31):simvastatin was not administrated before AMI.Twenty-four hours after AMI,the serum levels of hs-CRP、ET-1,and CK-MB of all the patients were measured with enzyme-linked immunosorbent assay(ELISA)and/or immunoradiometric assay(IRMA)pespectively.Results Serum levels of hsCRP、ET-1 and CK-MB were all much lower in simvastatin treatment group than those in control group(P<0.05).Conclusion Simvastatin could inhibit the inflammatory reaction,ameliorate endothelial function,increase the paque stability and reduce AMI areas.
【Key words】Myocardial infarction; Simvastatin; C-reactive protein; Endothlin-1
作者单位:753000宁夏石嘴山市第二人民医院心内科
内皮功能失调、炎症反应是冠状动脉粥样斑块不稳定、破裂、血栓形成的主要因素,冠状动脉痉挛也参与其中。血清高敏C-反应蛋白(hs-CRP)是炎症的敏感指标,内皮素(ET)反应血管内皮依赖性收缩功能,其升高是内皮受损的重要表现,二者可预测急性心肌梗死(AMI)的严重程度和预后[1]。心肌肌酸激酶同功酶(CK-MB)是心肌特异性酶,升高程度反应心肌损伤程度和梗死面积。据报道,降低CRP水平可减少心血管事件的发生,他汀类降脂药可降低AMI患者病死率[2],他汀类药物具有改善内皮功能、影响斑块稳定性及防止血栓形成和抗炎作用。本研究通过观察辛伐他汀对急性心肌梗死(AMI)患者血hs-CRP、ET-1、CK-MB,探讨其对内皮功能、斑块稳定性和梗死范围的影响。
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