中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2011年
7期
14-17
,共4页
韩增雷%张玉英%曹庆博%王津文
韓增雷%張玉英%曹慶博%王津文
한증뢰%장옥영%조경박%왕진문
冠状动脉疾病%C反应蛋白质%阿托伐他汀%可溶性CD105%心率震荡
冠狀動脈疾病%C反應蛋白質%阿託伐他汀%可溶性CD105%心率震盪
관상동맥질병%C반응단백질%아탁벌타정%가용성CD105%심솔진탕
Coronary disease%C-reactive protein%Atorvastatin%Soluble CD105%Heart rate turbulence
目的 通过观察血清可溶性CD105.(sCD105)、高敏C反应蛋白(hs-CRP)及心率震荡参数的变化,探讨阿托伐他汀强化治疗急性冠状动脉综合征(ACS)的效果及意义.方法 将106例ACS患者按随机数字表法分为治疗1组(38例,常规治疗+阿托伐他汀20 mg)、治疗2组(38例,常规治疗+阿托伐他汀40mg)和对照组(30例,仅给予常规治疗),测定三组治疗前及治疗4周后的心率震荡参数及sCD105、hs-CRP水平,并进行比较.结果 治疗前三组震荡初始(TO)、震荡斜率(TS)、sCD105、hs-CRP比较差异无统计学意义(P＞0.05).治疗后三组TO、sCD105、hs-CRP均明显下降,TS明显升高(P＜0.05或＜0.01),而治疗2组改变最显著,治疗后治疗2组上述指标与治疗1组比较差异均有统计学意义[TO比较:(0.22±0.18)%比(0.66±0.23)%;TS比较:(6.22±0.83)ms/RR间期(RRI)比(3.90±0.73)ms/RRI;sCD105比较:(1.65±0.43)mg/L比(2.92±0.50)mg/L;hs-CRP比较:(1.68±0.55)mg/L比(2.08±0.61)mg/L](P＜0.01).相关分析表明,sCD105、hs-CRP水平与TO呈显著正相关(P＜0.01),而与TS呈显著负相关(P＜0.01).结论 ACS患者给予阿托伐他汀治疗,可稳定冠状动脉血管内皮及粥样斑块,改善自主神经功能,大剂量应用更能获益.
目的 通過觀察血清可溶性CD105.(sCD105)、高敏C反應蛋白(hs-CRP)及心率震盪參數的變化,探討阿託伐他汀彊化治療急性冠狀動脈綜閤徵(ACS)的效果及意義.方法 將106例ACS患者按隨機數字錶法分為治療1組(38例,常規治療+阿託伐他汀20 mg)、治療2組(38例,常規治療+阿託伐他汀40mg)和對照組(30例,僅給予常規治療),測定三組治療前及治療4週後的心率震盪參數及sCD105、hs-CRP水平,併進行比較.結果 治療前三組震盪初始(TO)、震盪斜率(TS)、sCD105、hs-CRP比較差異無統計學意義(P＞0.05).治療後三組TO、sCD105、hs-CRP均明顯下降,TS明顯升高(P＜0.05或＜0.01),而治療2組改變最顯著,治療後治療2組上述指標與治療1組比較差異均有統計學意義[TO比較:(0.22±0.18)%比(0.66±0.23)%;TS比較:(6.22±0.83)ms/RR間期(RRI)比(3.90±0.73)ms/RRI;sCD105比較:(1.65±0.43)mg/L比(2.92±0.50)mg/L;hs-CRP比較:(1.68±0.55)mg/L比(2.08±0.61)mg/L](P＜0.01).相關分析錶明,sCD105、hs-CRP水平與TO呈顯著正相關(P＜0.01),而與TS呈顯著負相關(P＜0.01).結論 ACS患者給予阿託伐他汀治療,可穩定冠狀動脈血管內皮及粥樣斑塊,改善自主神經功能,大劑量應用更能穫益.
목적 통과관찰혈청가용성CD105.(sCD105)、고민C반응단백(hs-CRP)급심솔진탕삼수적변화,탐토아탁벌타정강화치료급성관상동맥종합정(ACS)적효과급의의.방법 장106례ACS환자안수궤수자표법분위치료1조(38례,상규치료+아탁벌타정20 mg)、치료2조(38례,상규치료+아탁벌타정40mg)화대조조(30례,부급여상규치료),측정삼조치료전급치료4주후적심솔진탕삼수급sCD105、hs-CRP수평,병진행비교.결과 치료전삼조진탕초시(TO)、진탕사솔(TS)、sCD105、hs-CRP비교차이무통계학의의(P＞0.05).치료후삼조TO、sCD105、hs-CRP균명현하강,TS명현승고(P＜0.05혹＜0.01),이치료2조개변최현저,치료후치료2조상술지표여치료1조비교차이균유통계학의의[TO비교:(0.22±0.18)%비(0.66±0.23)%;TS비교:(6.22±0.83)ms/RR간기(RRI)비(3.90±0.73)ms/RRI;sCD105비교:(1.65±0.43)mg/L비(2.92±0.50)mg/L;hs-CRP비교:(1.68±0.55)mg/L비(2.08±0.61)mg/L](P＜0.01).상관분석표명,sCD105、hs-CRP수평여TO정현저정상관(P＜0.01),이여TS정현저부상관(P＜0.01).결론 ACS환자급여아탁벌타정치료,가은정관상동맥혈관내피급죽양반괴,개선자주신경공능,대제량응용경능획익.
Objective To investigate the clinical effects and significance of different-dose atorvastatin on soluble CD105(sCD105),high sensitive-C reactive protein(hs-CRP)and the parameters of heart rate turbulence in patients with acute coronary syndrome(ACS). Methods One hundred and six ACS patients were divided into three groups by random digits table: control group(30 patients, routine treatment),treatment group Ⅰ(38 patients, routine treatment + atorvastatin 20 mg), and treatment group Ⅱ(38patients, routine treatment + atorvastatin 40 mg). All patients were treated for 4 weeks. The levels of serum sCD105,hs-CRP,and the parameters of heart rate turbulence before and after treatment. Results Before treatment, the levels of turbulence onset(TO), turbulence slope(TS),sCD105 and hs-CRP in three groups had no significant difference(P ＞ 0.05). After treatment, TO,sCD105 and hs-CRP decreased significantly,and TS increased significantly(P＜ 0.05 or ＜ 0.01). The change amplitude of treatment group Ⅱ was the most obvious, and the levels of above mentioned index showed significantly difference compared with that of treatment group Ⅰ[TO:(0.22 ±0.18)% vs.(0.66 ± 0.23)%;TS:(6.22 ±0.83)ms/RR interval(RRI)vs.(3.90 ±0.73)ms/RRI;sCD105:(1.65 ±0.43)mg/L vs.(2.92 ±0.50)mg/L;hs-CRP:(1.68 ±0.55)mg/L vs.(2.08±0.61)mg/L](P ＜0.01). Correlation analysis showed the levels of sCD105 and hs-CRP had significantly positive correlation with TO(P ＜ 0.01)and had negative correlation with TS(P ＜ 0.01).Conclusions The atorvastatin treatment in patients with ACS may stabilize coronary vascular endothelial cells and atherosclerotic plaque, and improve autonomic nerve function. Larger doses of atorvastatin may get more benefit.
