瑞舒伐他汀与阿托伐他汀对冠心病高脂血症患者血脂及血浆ADMA水平的影响

目的:探讨瑞舒伐他汀与阿托伐他汀对冠心病高脂血症患者血脂及血浆不对称二甲基精氨酸(ADMA)水平的影响。方法:选取2016年3月-2017年12月四川大学华西医院收治的冠心病高脂血症患者210例为研究对象,随机分为研究组与对照组,每组各105例,研究组患者给予瑞舒伐他汀治疗,对照组给予阿托伐他汀治疗,均连续治疗8周。比较两组患者治疗前及治疗8周后血脂水平、ADMA水平及血清炎症因子水平、血管内皮功能指标水平,记录两组患者的不良反应发生情况。结果:两组患者治疗前及治疗8周后甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平比较无统计学差异(P0.05),两组患者治疗8周后TG、TC、LDL-C水平均较治疗前降低(P0.05),而HDL-C水平与治疗前相比无统计学差异(P0.05)。两组患者治疗8周后ADMA、超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)水平均较治疗前降低,且研究组低于对照组(P0.05)。治疗8周后两组患者内皮素-1(ET-1)水平较治疗前降低,一氧化氮(NO)水平较治疗前升高(P0.05),且研究组患者ET-1水平低于对照组,NO水平高于对照组(P0.05)。研究组与对照组患者在治疗期间均未发生难以耐受的不良反应。结论:与阿托伐他汀相比,应用瑞舒伐他汀治疗冠心病高脂血症患者可改善血管内皮功能和TG、TC、LDL-C水平,减轻炎症反应,降低ADMA水平,无严重不良反应发生,值得临床推广。

Effects of Rosuvastatin and Atorvastatin on Blood Lipid and Plasma ADMA Levels in Patients with Hyperlipidemia in Coronary Heart Disease

ABSTRACT Objective: To investigate the effects of rosuvastatin and atorvastatin on blood lipid and plasma asymmetric two methyl arginine (ADMA) levels in patients with hyperlipidemia in coronary heart disease. Methods: A total of 210 patients with hyperlipidemia in coronary heart disease, who were treated in West China Hospital of Sichuan University from March 2016 to December 2017, were selected and were randomly divided into study group(n=105) and control group(n=105). The study group was treated with rosuvastatin and the control group was treated with atorvastatin for 8 weeks of continuous treatment. The levels of blood lipid, ADMA, serum inflammatory factors and vascular endothelial function were compared between the two groups before treatment and 8 weeks after treatment; the incidence of adverse reactions in the two groups was recorded. Results: There were no significant differences in the levels of triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) between the two groups before treatment and 8 weeks after treatment (P>0.05). The levels of TG, TC and LDL-C of the two groups 8 weeks after treatment were lower than before treatment (P<0.05), but there was no statistical difference in HDL-C level compared with before treatment (P>0.05). The levels of ADMA, high sensitivity C reactive protein (hs-CRP) and interleukin -6 (IL-6) in the two groups 8 weeks after treatment were all lower than those before treatment, and the study group was lower than that in the control group (P<0.05). The level of endothelin -1 (ET-1) in the two groups 8 weeks after treatment was lower than that before treatment,and the level of nitric oxide (NO) was higher than that before treatment (P<0.05), and the level of ET-1 in the study group was lower than that of the control group, and the level of NO was higher than that of the control group (P<0.05). The patients in the two groups had no intolerant adverse reactions during the treatment. Conclusion: Compared with atorvastatin, the use of rosuvastatin in the patients with hyperlipidemia in coronary heart disease can improve vascular endothelial function, TG, TC and LDL-C levels, and it can reduce the inflammatory response and reduce the level of ADMA, without serious adverse reactions, which is worthy of clinical promotion.