摘要
目的:检测急性冠状动脉综合征(ACS)患者外周血中炎性细胞因子和高敏C反应蛋白,并观察早期使用阿托伐他汀对上述指标的影响,探讨他汀类药物治疗ACS的可能机制。方法:测定60例ACS患者、30例稳定型心绞痛(SA)患者和30例正常对照者的血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、干扰素γ(INF-γ)、可溶性细胞间黏附分子-1(sICAM-1)和高敏C反应蛋白(hs-CRP)以及TC、TG、HDL-C和LDL-C水平。并将60例ACS患者随机分为2亚组:他汀亚组和常规亚组,2亚组均予常规治疗,他汀亚组加服阿托伐他汀钙片。干预3周后对他汀亚组及常规亚组再次采血测定上述指标,比较2亚组药物干预后血清IL-6、TNF-α、INF-γ、sI-CAM-1、hs-CRP的变化以及与血脂变化的相关性。结果:ACS组IL-6、TNF-α、sICAM-1和hs-CRP水平均明显高于SA组及对照组,均差异有统计学意义,INF-γ水平差异无统计学意义;他汀亚组与常规亚组比较IL-6、TNF-α、sICAM-1和hs-CRP治疗后明显下降,差异有统计学意义。他汀亚组IL-6、TNF-α、sICAM-1及hs-CRP的下降与血脂下降无关。结论:测定血清IL-6、TNF-α、sICAM-1和hs-CRP水平可了解炎症反应的强度。阿托伐他汀具有独立于降脂作用之外的抗炎症反应作用,此作用可能是稳定易损斑块的早期机制之一。
Objective：To evaluate the inflammatory markers which could be clues on vulnerable plaque in serum of patients with acute coronary syndrome （ACS） and the effect of atorvastatin on them. Method： Serum levels of interleukin-6 （IL-6）, tumor necrosis factor-α（TNF-α）, interferon-γ（INF-γ）, soluble intercellular adhesion molecule-1 （sICAM-1）, high-sensitivity C-reactive protein （hs-CRP） , total cholesterol （TC）, triglyceride（TG）, low density lipoprotein cholesterol （LDL-C） and high density lipoprotein cholesterol （HDL-C） were measured in 60 patients with ACS, 30 patients with stable angina （SA） and 30 normal people as control before treatment. In ACS group, 60 patients with ACS were randomly individed into two subset groups： the atorvastatin group and routine group. Atorvastatin group was given atorvastatin 20 mg/d besides routine treatment, while routine group was accepted in routine treatment. Levels of serum IL-6, TNF-α,INF-γ,sICAM-1, hs-CRP and serum lipids concentrations were measured again at three weeks after treatment in the two subgroups. Result：Levels of serum IL-6, TNF- α, sICAM-1 and hs-CRP were significantly higher in ACS group than those in SA and normal control group. There was no different to the level of INF -γ in these groups. After three weeks＇ administration, the decreasing concentration of IL-6,TNF-α, sICAM-1 and hs-CRP were obtained in atorvastatin group, compared with routine group. No relationship was observed between the levels of above inflammatory markers and serum lipids levels. Conclusion：Serum of IL-6, TNF-α, sICAM-1 and hs-CRP might be the inflammatory markers in ACS and INF-γ have no significant predict value for the ACS. Atorvastatin could influence the expressions of IL-6, TNF-α, sICAM-1 and hs-CRP, suggesting the anti-inflammatory effect independent of lipid lowering action in ACS.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2007年第8期572-575,共4页
Journal of Clinical Cardiology
