血管紧张素转化酶抑制剂与他汀药物对控制血管炎症反应的协同作用  

Synergistic effects of angiotensin converting enzyme inhibitors and statins on vascular inflammation

作　　者：齐杰[1] 王继荣[1] 来春林[1] 

机构地区：[1]山西省人民医院心内科,太原030012

出　　处：《中国药物与临床》2014年第4期450-451,共2页Chinese Remedies & Clinics

基　　金：山西省科技攻关项目(20120313018-8)

摘　　要：目的观察他汀类药物与血管紧张素转换酶抑制剂(ACEI)对于降低血管炎症反应的协同作用。方法 120例急性心肌梗死患者随机分为阿托伐他汀组(在常规治疗基础上加用阿托伐他汀40 mg/晚)、阿托伐他汀+雷米普利组(在常规治疗基础上加用阿托伐他汀40 mg/晚、雷米普利5 mg/d联合治疗);60例冠状动脉造影正常作为对照组。结果①急性心肌梗死患者外周血高敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6水平高于冠状动脉造影正常的对照组(均P<O.05);②阿托伐他汀与雷米普利5 mg联合降低hs-CRP、TNF-α、IL-6水平于治疗1周后效果优于单独使用阿托伐他汀组(均P<0.05)。结论①炎症因子参与急性心肌梗死的发生、发展过程;②他汀类药物和ACEI早期治疗急性心肌梗死患者,能够更有效降低炎性因子水平,更多获益。Objective To determine the synergistic effects of statins and angiotensin converting enzyme in- hibitors （ACEI） on alleviating the vascular inflammation. Methods One hundred and twenty patients with acute my- ocardial infarction were randomly allocated to be treated with routine therapy plus atmvastatin 40 mg once per night alone （atorvastatin group） or in combination with ramipril 5mg once daily （atorvastatin＋ramipril group）. 60 patients with normal coronary angiography findings were enrolled as normal controls. Results Patients with acute myocardial infarction yielded markedly higher levels of peripheral blood hypersensitive C-reactive protein （hs-CRP）, tumor necro- sis factor-α （TNF-c0 and interleukin-6 （IL-6） than normal controls （all P〈0.05）. A more pronounced reduction in hs- CRP, TNF-α and IL-6 was observed in atorvastatin＋ramipril group at week 1 （all P〈0.05）. Conclusion Inflammatory cytokines are involved in the pathogenesis and development of acute myocardial infarction. The combination of statins and ACEI more effectively reduces the levels of inflammatory mediators leading to dramatic benefits for the early treatment in patients with acute myocardial infarction.

关 键 词：心肌梗塞 白细胞介素6 阿托伐他汀 INTERLEUKIN-6 

分 类 号：R969.2[医药卫生—药理学]