| Objective: To explore the anti-inflammatory mechanism of atorvastatin in the early treatment of coronary heart disease(CHD),and simultaneously evaluate the clinical effect of anti-inflammation by atorvastatin in groups with different dosages.Methods: 74 patients who were definitely diagnosed with CHD and performed with coronary angiography for the first time,but no Percutaneous coronary intervention and had been oral statins in the department of cardiology of the Second Hospital of Jilin University from Jannary 2016 to December 2016 had been selected as the object of study and randomly divided into: control group(20 cases),group A(27 cases)and group B(27 cases).The patients were all administered with a conventional therapy,The patients in the control group were with 20 mg atorvastatin calcium tablet before bedtime every day?The patients in the group A were with 40 mg atorvastatin calcium tablet before bedtime every day,andthe ones in the group B were 60 mg.The general data of the patients was collected on the day of admission:age,gender,smoking percentage,drinking percentage,Body Mass Index(BMI),hypertension percentage,Systolic blood pressure(SBP),Diastolic blood pressure(DBP),heart rate,White blood cell(WBC),Platelet(PLT),Uric acid(UA)and Homocysteine(Hcy).And the subjects with Heme oxygenase-1(HO-1),Highly sensitive C-reactive protein(hs-CRP)and Tumor necrosis factor-?(TNF-?)were tested on the day of admission(D1)and three and seven days after admission(D3 and D7).On D1 and D7,the subjects were tested with the concentrations of Triglycerides(TG)?Total cholesterol(TC)? Low density lipoproteincholesterol(LDL-C)?High density lipoprotein-cholesterol,(HDL-C)?Alanine aminotransferase(ALT)? Aspartate transaminase(AST)and Creatine kinase,CK).The concentrations of HO-1 and TNF-?.were measured by enzyme-linked immunosorben assay.The fully automatic biochemical analyzer was adopted to determine the concentrations of hs-CRP?TG?TC?LDL-C?HDL-C?ALT?AST?creatinine and CK.All the data were statistically analysed andthe results were regarded as statistical significance when P was less than 0.05.Results: General data results:the differences in age,gender,smoking percentage,drinking percentage,BMI,hypertension percentage,SBP,DBP,heart rate,WBC,PLT,UA and Hcy were all not statistically significant(P>0.05)among the three groups.Concentration results of blood lipids:the differences in the concentrations of blood lipid on D1 were not statistically significant(P>0.05)among the three ones.The concentrations of TC and LDL-C were lower on D7 than D1 in the group B(P<0.05)and lower on D7 in the group B than group A and control group(P<0.05).Concentration results of HO-1:the differences in the concentrations of HO-1 were not statistically significant(P>0.05)among the three ones.Meanwhile,after being administered with atorvastatin,the concentrations of HO-1 had a clearly higher level in the group A than control group on D3 and D7(P<0.05)and it was the same results between the group B with the other ones on D3 and D7(P<0.05).Depending on the administration duration,the differences in the concentrations of HO-1 were not statistically significant(P>0.05)among the control group;while the concentrations of HO-1 increased gradually in the other groups,namely,these differences of the concentrations were statistically significant(P<0.05)on D1?D3 and D7,which were D1<D3<D7.Concentration results of of hs-CRP and TNF-?: the differences in the concentrations of hs-CRP and TNF-? among the three groups were not statistically significant(P>0.05).Meanwhile,after being administered with atorvastatin,the concentrations of hs-CRP and TNF-? had a clearly lower level in the group A than the control group on D3 and D7(P<0.05)and it was the same results between the group B with the other ones on D3 and D7(P<0.05).Depending on the administration duration,the differences in the concentrations of hs-CRP and TNF-? were not statistically significant(P>0.05)among the control group;while the concentrations of hs-CRP and TNF-? decreased gradually in the other groups,namely,these differences of the concentrations were statistically significant(P<0.05)on D1?D3 and D7,which were D1>D3>D7.Correlation analysis on the concentrations between HO-1 and hs-CRP and TNF-?:pearson linear correlation analysis was used to analyze the correlation between the concentrations of HO-1 and hs-CRP and TNF-? in 54 patients in the group A and B on D1 and after treatment(D3 and D7).The results revealed that the concentrations of HO-1 were negatively correlated with hs-CRP and TNF-?(r1=-0.373,r2=-0.401,P<0.01);meanwhile,the results of linear regression analysis revealed that the HO-1 expression quantity went up,the concentrations of hs-CRP and TNF-? went down(P<0.01).Security of atorvastatin: the differences in ALT,AST,creatinine and CK on D1 among the three groups were all not statistically significant(P>0.05);and the differences among themon D7 were similar as D1 in each group(P>0.05);Conclusion: 1?The early application of intensive of atrovastatin can effectively reduce the concentrations of TC and LDL-C among the patients with CHD.2?In the early period of CHD treatment by atorvastatin,HO-1 presents negative correlation with hs-CRP and TNF-?,which may be caused by inducing the up-regulated expression of HO-1,and further inhibiting hs-CRP and TNF-? level.3?For CHD patients,early taking large dose of atorvastatin can reduce level of inflammatory factors hs-CRP and TNF-?,and the more larger of the dose,the lower of hs-CRP and TNF-? level.4?The early application of intensive of atrovastatin has no adverse effects and a good security among the patients with CHD. |
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