美国学者的一项研究表明，80 mg/天阿托伐他汀可通过显著缩短中位C反应蛋白（CRP）血浆滞留时间降低血浆CRP水平。论文于发表于《动脉粥样硬化》[Atherosclerosis 2013；226（2）：466-470]。
此项随机、安慰剂对照、双盲、交叉研究共纳入8例混合性高脂血症患者（男性5例，绝经后女性3例）。安慰剂和阿托伐他汀（80 mg/天）治疗8周后，受试者接受15小时氘化亮氨酸持续预输注。通过亲和层析从脂蛋白缺乏血浆中分离CRP。利用气相色谱-质谱确定同位素富集，并利用房室模型确定动力学参数。
结果显示，与安慰剂相比，阿托伐他汀使中位CRP池大小降低28.4%（13.31±3.78对10.26±3.93 mg；P=0.16），与中位CRP部分分解代谢率增加39.9%相关（0.34±0.06对0.50 ± 0.11/天；P=0.09），并未为显著影响中位CRP产生率（0.050±0.01对0.049±0.01 mg/kg/天P=0.78）。
Effects of atorvastatin on human C-reactive protein metabolism
Objective
Statins are known to reduce plasma C-reactive protein (CRP) concentrations. Our goal was to define the mechanisms by which CRP was reduced by maximal dose atorvastatin.
Methods
Eight subjects with combined hyperlipidemia (5 men and 3 postmenopausal women) were enrolled in a randomized, placebo-controlled double-blind, cross over study. Subjects underwent a 15-h primed-constant infusion with deuterated leucine after 8 weeks of placebo and 80 mg/day of atorvastatin. CRP was isolated from lipoprotein deficient plasma, (density > 1.21 g/ml) by affinity chromatography. Isotopic enrichment was determined by gas chromatography/mass spectrometry. Kinetic parameters were determined using compartmental modeling. Paired t test and Wilcoxon signed ranks test were used to compare differences between placebo and atorvastatin.
Results
Compared with placebo, atorvastatin decreased median CRP pool size by 28.4% (13.31 ± 3.78 vs 10.26 ± 3.93 mg; p = 0.16), associated with a median CRP fractional catabolic rate increase of 39.9% (0.34 ± 0.06 vs 0.50 ± 0.11 pools/day; p = 0.09), with no significant effect on median CRP production rate (0.050 ± 0.01 vs 0.049 ± 0.01 mg/kg/day; p = 0.78).
Conclusion
Our data indicate that maximal doses of atorvastatin lower plasma CRP levels by substantially decreasing the median CRP plasma residence time from 2.94 days to 2.0 days, with no significant effect on the median CRP production rate.
来源：CMT 高晓方 编译
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