西洛他唑对急性冠状动脉综合症患者炎症因子及血脂水平的影响  

Effect of Cilostazol on Inflammatory Cytokine and Blood Lipids in Acute Coronary Syndrome

作　　者：李晓英[1] 王兆宏[1] 刘国英[2] 陈还珍[2] 

机构地区：[1]山西中医学院中西医结合医院心内科 [2]山西医科大学第一医院心内科,山西省太原市030001

出　　处：《中国动脉硬化杂志》2007年第10期773-776,共4页Chinese Journal of Arteriosclerosis

摘　　要：目的观察在他汀类药物基础上加用西洛他唑对急性冠状动脉综合症患者炎症因子及血脂水平的影响。方法将60例急性冠状动脉综合症患者随机分为基本治疗组(常规用药+阿托伐他汀)和西洛他唑组(西洛他唑+常规用药+阿托伐他汀),观察治疗3周后血脂、肿瘤坏死因子α、白细胞介素1β和高敏C反应蛋白的变化、临床疗效及不良反应。结果治疗后总胆固醇、甘油三酯和低密度脂蛋白胆固醇水平较治疗前明显下降(P<0.05),下降幅度组间比较无显著差异(P>0.05);治疗后高密度脂蛋白胆固醇水平上升,但西洛他唑组上升幅度明显大于基本治疗组(P<0.01);治疗后肿瘤坏死因子α、白细胞介素1β和高敏C反应蛋白水平均明显下降(P<0.05),但西洛他唑组下降幅度大于基本治疗组(P<0.01);用西洛他唑治疗前后肿瘤坏死因子α、白细胞介素1β变化值与高密度脂蛋白变化值呈负相关(r=-0.38,P=0.04;r=-0.39,P=0.03);西洛他唑组胸痛缓解明显,无不良反应。结论阿托伐他汀联用西洛他唑较单用阿托伐他汀可进一步升高高密度脂蛋白水平,降低致炎因子浓度,二者协同发挥抑制炎症、稳定斑块的作用。Aim To observe the efect of cilostazol on the serum levels of inflammatory cytokine in acute coronary syndrome. Methods 60 selected patients were randomly divided into two groups： basic treatment group （conventional medication plus atorvastatin） and cilostazol group （basic treatment plus cilostazol）. The change of some indicator levels, including blood lipids, tttmor necrosis factor-α （TNF-α）, interleukin-1β （IL-1β）, high sensitivity C-reactive protein （hs-CRP） was measured after three weeks of treatment. Clinical therapeutic effect and adverse reactions was monitored treatment, the serum levels of cholesterol, triglycoride and low density lipoprotein cholesterol （LDLC） in both groups decreased slightly （ P 〈 0.05 ）, but there was no significance in the decreased degree between both groups. The increase of high density lipoprotein cholesterol （HDLC）was observed in both groups, but the increased degree was significantly higher in cilostazol group than in basic treatment group （ P 〈 0.01） . The serum levels of TNF-α, IL-1β, hs-CRP declined in both groups（P〈0.05）, but the degree of reduction of them was greater in t ilostazol group than in basic treatment group （ P 〈 0.01 ）. The reduction of TNF-α and IL- 1β was negatively correlated with the increase of HDLC in cilostazol group （ r = - 0.38, P = 0.04; r = - 0.39, P = 0.03 ）. Medication group could obviously ease chest pain with no adverse reactions. Conclusion The use of cilostazol joint atorvastatin on the basis of conventional treatment, compared with atorvastatin alone, could furtherly increased HDLC, reduced inflammatory cytokine concentration, promoted the stability of atherosclerotic plaque.

关 键 词：内科学 阿托伐他汀 西洛他唑 急性冠状动脉综合症 高敏C反应蛋白 肿瘤坏死因子A 白细胞介素1Β 

分 类 号：R5[医药卫生—内科学]