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目的:观察急性冠状动脉综合征(ACS)病人早期使用两种剂量辛伐他汀(40mg/d;20mg/d)对血浆超敏C反应蛋白(hs-CRP)及颈动脉粥样硬化的影响。方法:对80例ACS病人随机分为两组,治疗组40例,40mg/d辛伐他汀;对照组40例,20mg/d辛伐他汀。随访12mo,观察调脂疗效,血浆hs-CRP浓度,彩色多普勒技术测定颈动脉内膜厚度及颈动脉斑块变化。结果:治疗组和对照组治疗4wk,均能显著降低血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)及hs-CRP,升高高密度脂蛋白胆固醇(HDL-C)(P<0.01),但40mg于20mg组比较差异有显著性(P<0.05);并降低双侧颈动脉内膜厚度,斑块面积缩小。两组比较,差异有显著性(P<0.01)。结论:ACS早期应用40mg/d辛伐他汀治疗,能有效调降脂,明显抑制超敏C反应蛋白,从而有利于动脉粥样硬化斑块的稳定性。
Objective: To observe the effects of early use of two doses of simvastatin (40 mg / d; 20 mg / d) on plasma hs-CRP and carotid atherosclerosis in patients with acute coronary syndrome (ACS). Methods: Eighty patients with ACS were randomly divided into two groups: 40 in treatment group and 40 mg / d simvastatin in control group, 40 in control group and 20 mg / d simvastatin in control group. Followed up for 12 months, observed lipid-lowering effect, plasma hs-CRP concentration, color Doppler measured carotid artery intima-media thickness and carotid plaque changes. Results: The treatment group and the control group could significantly reduce the levels of serum total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL-C) and hs-CRP and increase high density lipoprotein cholesterol HDL-C) (P <0.01), but there was a significant difference between the 40mg group and the 20mg group (P <0.05). The bilateral carotid intima-media thickness and plaque area were reduced. The difference between the two groups was significant (P <0.01). Conclusion: ACS treatment with 40 mg / d simvastatin can reduce lipid levels and significantly inhibit hypersensitive C-reactive protein, which is beneficial to the stability of atherosclerotic plaque.