调脂和抗血小板治疗对内皮脂肪酶表达的影响  

Effects of lipid-modulation and antiplatelet treatment on the endothelial lipase expression

作　　者：方玉强[1] 何多芬[1] 杨成明[1] 王旭开[1] 曾春雨[1] 王红勇[1] 傅春江[1] 石伟彬[1] 张晔[1] 

机构地区：[1]解放军第三军医大学大坪医院野战外科研究所心血管内科,重庆400042

出　　处：《中国危重病急救医学》2010年第11期663-665,共3页Chinese Critical Care Medicine

基　　金：国家自然科学基金资助项目（30470729）

摘　　要：目的 了解调脂治疗和抗血小板治疗对冠心病患者内皮脂肪酶（EL）表达的影响,进一步探讨EL在冠心病中的作用.方法 将157例冠心病患者按临床表现和冠状动脉（冠脉）造影结果分为3组：对照组41例,有1项以上冠心病危险因素,但冠脉狭窄程度＜30%;稳定型心绞痛（SAP）组55例;急性冠状动脉综合征（ACS）组61例.在禁用调脂药和阿司匹林2周后取血查EL阳性细胞率,均给予患者辛伐他汀和（或）拜阿司匹林,如出现并发症或不能依从者停药,6个月后复查EL阳性细胞率.结果 除对照组单用拜阿司匹林外,各组患者不论单用辛伐他汀或拜阿司匹林,还是两药联用,EL阳性细胞率均显著下降[单用辛伐他汀对照组：（3.93±0.87）%比（5.28±1.05）%,SAP组：（8.16±2.11）%比（15.12±2.53）%,ACS组：（13.93±3.22）%比（38.44±4.36）%;单用拜阿司匹林SAP组：（10.57±4.07）%比（14.66±2.29）%,ACS组：（18.28±5.14）%比（40.27±3.96）%;联合用药对照组：（3.13±0.87）%比（5.33±1.25）%,SAP组：（5.68±2.20）%比（14.89±2.15）%,ACS组：（7.81±3.96）%比（39.27±5.17）%,P＜0.05或P＜0.01].结论 调脂治疗和抗血小板治疗能有效抑制内皮细胞表达EL,提示EL参与了冠心病的发病过程.Objective To investigate the effects of lipid-modulation and antiplatelet treatment on the expression of endothelial lipase （EL） of patients with coronary artery disease （CAD）, and investigate the role of EL in the development of CAD.Methods One hundred and fifty-seven cases were divided into three groups according to clinical manifestations and the results of coronary artery angiography： control group （n=41） with more than one risk factors of CAD and the vessel lesions was 〈30%; stable angina pectoris （SAP）group （n=55）; acute coronary syndrome （ACS） group （n= 61）.The EL positive cell rate was measured 2 weeks after cessation of lipid-sodulation and aspirin treatment, and 6 months after treatment with simvastatin and/or aspirin.The drug was ceased for the complications or not tolerance for the treatment.Results Except the patients in control group with aspirin treatment, the EL positive cell rate was significantly decreased among other groups[control group with simvastatin： （3.93 ± 0.87） % vs.（5.28 ±1.05）%, SAP group： （8.16±2.11）% vs.（15.12±2.53）%, ACS group： （13.93±3.22）% vs.（38.44±4.36）%; SAP group with aspirin： （10.57±4.07）% vs.（14.66±2.29）%, ACS group： （18.28±5.14）%vs.（40.27±3.96）%; control group with aspirin and simvastatin： （3.13±0.87）% vs.（5.33± 1.25）%,SAP group： （5.68±2.20）% vs.（14.89±2.15）%, ACS group： （7.81±3.96）% vs.（39.27±5.17）%,P〈0.05 or P〈 0.01].Conclusion The treatment with lipid-modulation and/or antiplatelet drug may significantly decrease the expression of EL, implying that EL participates in the progression of CAD.

关 键 词：冠心病 内皮脂肪酶 辛伐他汀 拜阿司匹林 

分 类 号：R686[医药卫生—骨科学]