老年急性冠脉综合征患者血清sICAM-1、sVCAM-1变化及影响因素和瑞舒伐他汀的干预作用  

The plasma levels changes and influence factors of sICAM-1,sVCAM-1 in elderly patients with acute coronary syndrome and intervention by rosuvastatin

作　　者：潘凌云[1] 朱贵月[1] 马晓静[1] 王勇[1] 苑海涛[1] 唐元升[1] 崔连群[1] 朱兴雷[1] 

机构地区：[1]山东大学附属省立医院心内科,山东济南250021

出　　处：《中国老年学杂志》2011年第1期38-40,共3页Chinese Journal of Gerontology

基　　金：山东省自然科学基金(Q2007C10);山东省卫生厅青年基金(2007QW024)

摘　　要：目的检测老年急性冠脉综合征(ACS)患者血清可溶性细胞间黏附分子-1(sICAM-1)和血管细胞黏附分子-1(sVCAM-1)水平,观察血压、血糖、血脂与血清sICAM-1和sVCAM-1的相关性及早期应用瑞舒伐他汀对血清sICAM-1和sVCAM-1的影响,探讨他汀药物降低ACS炎症反应的可能机制。方法 112例老年冠心病患者稳定性心绞痛(SAP)组36例,ACS组76例,将后者分为常规治疗组、瑞舒伐他汀组。用ELISA法测定老年ACS患者入院后第1、3、5、7天和2 w后sICAM-1和sVCAM-1浓度,用常规治疗方法作为对照,观察瑞舒伐他汀对其sICAM-1和sVCAM-1水平的影响。另根据ACS患者是否有高血压、糖尿病、高血脂病史,分析其与血清sICAM-1和sVCAM-1关系。常规测量血压,测定血糖、血脂,分析其与sI-CAM-1和sVCAM-1的相关性。结果老年ACS患者入院时血清sICAM-1和sVCAM-1浓度比SAP组明显增高(P<0.01)。ACS患者高血压组较正常血压组、糖尿病组较非糖尿病组、高血脂组较正常血脂组血清sICAM-1、sVCAM-1水平明显增高(P均<0.01)。ACS患者血清sICAM-1和sVCAM-1与LDL-C呈正相关(P<0.01),与心率、收缩压、舒张压、TC、HDL-C、TG、FBG、HbA1C无显著相关性(P>0.05)。ACS患者瑞舒伐他汀组较常规治疗组血清sICAM-1和sVCAM-1水平下降显著(P<0.01)。结论 ACS患者血清sICAM-1、sVCAM-1水平升高,炎症反应增强;高血压、糖尿病、高血脂导致的血管内皮损伤是血清sICAM-1、sVCAM-1水平升高的重要因素;瑞舒伐他汀可以降低炎症反应,在ACS的早期治疗中起重要作用。Objective To observe the relations of soluble intercellular adhesion molecules-1（sICAM-1）,vascular cell adhesion molecules-1（sVCAM-1）to blood pressure,blood sugar,blood lipid and the influence of rosuvastatin on sICAM-1 and sVCAM-1 in serum of patients with acute coronary syndrome（ACS）,to probe into the mechanism of rosuvastatin lowering inflammatory reaction in ACS patients.Methods 112 elderly patients were divided into two groups：36 patients with stable angina pectoris（SAP）,76 patients with ACS.The latter group were randomly divided into rosuvastatin and non-rosuvastatin sub-groups.Serum concentrations of sICAM1 and sVCAM-1 in patients with ACS were measured by ELISA at 1,3,5,7,14 day after hospitalization.Moreover,the relations of sICAM-1 and sVCAM-1 to the history of hypertension,diabetes mellitus,dyslipidemia as well as blood pressure,blood sugar,blood lipid were analyzed.Results Serum concentrations of sICAM-1 and sVCAM-1 in elderly patients with ACS were higher than those of SAP group（P0.01）.sICAM-1,sVCAM-1 levels in plasma were higher in hypertension,diabetes mellitus,dyslipidemia groups than normal pressure,non-diabetes,normal lipid respectively.Mutivariable analysis showed that sICAM-1,sVCAM-1 levels in plasma were correlated to LDL-C positively（P0.01）but not heart rate,systolic pressure,diastolic pressure,TC,HDL-C,TG,FBG,HbA1C（P0.05）.In two sub-groups of ACS group,serum concentrations of sICAM-1 and sVCAM-1 in rosuvastatin group were decreased more significantly than those of the other.Conclusions Endothelium impairment induced by hypertension,diabetes mellitus,dyslipidemia is important factor of elevating sICAM-1,sVCAM-1 levels in plasma;Rosuvastatin may decrease inflammatory reaction and play a pivotal role in early therapy of ACS patients.

关 键 词：瑞舒伐他汀 急性冠状动脉综合征 可溶性细胞黏附分子 危险因素 

分 类 号：R543.3[医药卫生—心血管疾病]