早期调脂干预对急性心肌梗死患者炎症因子的影响  

Influence of early interventions for lipid lowering on inflammatory factors in patients with acute myocardial in- farction

作　　者：曾武涛[1] 冷秀玉[1] 王礼春[1] 廖新学[1] 马虹[1] 

机构地区：[1]中山大学附属第一医院心内科,广东广州510080

出　　处：《中国心血管杂志》2004年第5期333-336,共4页Chinese Journal of Cardiovascular Medicine

基　　金：广州市科委基金资助课题(编号:2002105)

摘　　要：目的观察早期较大剂量阿托伐他汀治疗急性心肌梗死(AMI)3d后患者血清可溶性CD40L(sCD40L)、P-选择素及可溶性血管粘附分子水平的变化,以探讨早期调脂干预对AMI斑块稳定、抑制炎症反应的作用。方法选取43例AMI患者随机分为常规治疗组(无服用任何调脂药物,21例)和阿托伐他汀组(立普妥20mg,qd,22例),测定治疗前后sCD40L、P-选择素、可溶性细胞间粘附分子-1(sICAM-1)和可溶性血管细胞间粘附分子-1(sV-CAM-1)的水平。结果两组治疗前后血脂水平变化无显著性差异。阿托伐他汀组治疗后血清sCD40L、P-选择素、sICAM-1分别下降35％、41％、30％,明显低于治疗前水平(P<0.05),sVCAM-1稍下降,但无统计学意义;在常规治疗组治疗前后上述指标均无明显变化。在阿托伐他汀组sCD40L、P-选择素、sICAM-1的降低与总胆固醇(TC)(分别为r=0.08,P=0.56;r=0.16,P=0.34;r=0.12,P=0.41),低密度脂蛋白胆固醇(LDL-C)(分别为r=0.09,P=0.88;r=0.11,P=0.46;r=0.18,P=0.77)的下降百分数之间无相关关系。结论在AMI的早期使用阿托伐他汀治疗3d,可明显降低血清炎症因子水平,可能有利于动脉粥样硬化斑块的稳定。Objective To observe the influence of interventions for lipid lowering on levels of serum soluble CD40L (sCD40L), P-selectin and soluble vascular adhesion molecules in patients with acute myocardial infarction within 3 days. Methods 43 patients with acute myocardial infarction were randomized to either atorvastatin group(20mg/d of atorvastatin for 3 days,n = 22) and control group (no lipid-lowering drugs, n = 21). Serum levels of sCD40L, P-selectin, soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sV-CAM-1) before and after treatment were measured. Results Levels of plasma lipid were not changed before and after therapy in both groups. Levels of sCD40L, P-selectin and sICAM-1 were significantly decreased 35%,41%, 30% by atorvastatin, respectively. Levels of sVCAM-1 were slightly decreased by atorvastatin(P>0. 05). In control group, the levels of sCD40L, P-selectin, sICAM-1 and sVCAM-1 were not changed. There were no relations between the decrease percent of sCD40L, P-selectin and sICAM-1 and that of TC and LDL-C. Conclusion Atorvastatin can significantly decrease serum levels of inflammatory factors in patients with acute myocardial infarction within the first 3 days, so it may benefit to atherosclerotic plaque stabilization.

关 键 词：阿托伐他汀 急性心肌梗死 CD40L P-选择素 粘附分子 

分 类 号：R542.22[医药卫生—心血管疾病]