| BackgroundAcute coronary Syndrome is an important occurrence in the procedure of atheromatosis,which conversion has a direct impact on the patient with coronary heart disease.Studies suggest that the major pathological foundation of ACS are coronary plaque rupture,surface damage or cracks,and then bleeding and thrombosis, leading to the incomplete or complete obstruction of coronary artery lumen.So the stability of plaque has a decisive action in the acute coronary syndrome. Recently,Most of scholars consider that artheroscleorsis is a kind of inflammation reaction.The inflammation participates in formation,development and rupture of artherosclerosis.studies show that C-reactive protein(CRP),an inflammatory marker,is discovered in the plaque of artherosclerosis,and it increases along with progression of plaque.The immune reaction of CRP is especially obvious in the core of plaque.The level of CRP in plasma is an independent risk factor of ACS occurrence(Plaque rupture),and it correlates with severity and prognosis of artherosclerosis.High sensistive C-reactive protein is measured by a more sensitive method.How to stabilize the unsatble plaque,decrease acute thrombus incident,and improve prognosis in patients with ACS,is a hot spot in our researches.And studies had made clear that statins could inhibit inflammation effects and stabilize the quality of plaque.Statins could significantly reduce the occurrence of acute coronary events.So statins can improve the prognosis of the patients with acute coronary syndrome.But whether statins could produce a marked effect in short-term is not clear.Something should be done to make sure whether statins can exert anti-inflammatory effects in short period and the relationship between drug dose and the effects in patients with ACS.ObjectiveTo observe the changes of plasma high sensitive C-reactive protein(hs-CRP) concentrations in the patients with acute coronary syndrome(ACS)after one and two-weeks treatment with different dosage of simvastatin(20mg,40mg or 60mg per day),and explore the influence of different dose simvastatin therapy on hs-CRP in short term to further explore the anti-inflammatory effects of statins and the relationship between drug dose and the effects.Methods126 patients with ACS were selected and were randomly divided into three groups which receiving simvastatin 20mg per day(n=43),40mg per day(n=43) and 60mg per day(n=40).levels of total cholesterol(TC),triglycerides(TG),lower density lipid cholesterol(LDL-C),higher density lipid cholesterol(HDL-C)and hs- CRP of all patients were determined before,one week and two weeks after the treatment.Results1.Both TC and LDL-C were decreased after two weeks therapy in the three groups(P＜0.05),the 60mg simvastatin treatment group has move significantly benefits(P＜0.01),but the TG and HDL-C levels were not significantly changed (P＞0.05).2.The plasma hs-CRP level had a downward trend in the three groups.The plasma hs-CRP level were significantly decreased in 60mg simvastatin treatment groups(P＜0.05) after 1 week therapy and in 20mg simvastatin treatment groups(P＜0.05) after 2 weeks therapy.The plasma level of hs-CRP had more significantly decreased in 60mg and in 40mg simvastatin treatment groups(P＜0.01) than in 20mg simvastatin treatment group after 2 weeks therapy.3.Correlaton analysis showed that reduction of plasma hs-CRP level was not related to changes of plasma lipid level.ConclusionSimvastatin may significantly reduce plasma hs-CRP levels in a dose-dependent manner in ACS patients and has an anti-inflammatory therapeutic effect and may stabilize atherosclerotic plaques in short term,which beyond lipid-lowering and intensive simvastatin treatment may have more significant benefits. |
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