不稳定型心绞痛血浆P-选择素水平变化及调脂干预的研究  

Changes in plasma Pselectin level and interventions for lipid lowering in patients with unstable angina pectoris

作　　者：吕以杰[1] 郭玉清[1] 孙德成[1] 朱世明[1] 丁福生[1] 

机构地区：[1]山东省济南市中心医院心内科,山东济南250013

出　　处：《中国危重病急救医学》2001年第3期156-158,共3页Chinese Critical Care Medicine

基　　金：卫生部国际交流中心默沙东科研基金资助项目!( No.19980 2 16 )

摘　　要：目的 :观察不稳定型心绞痛血浆 P 选择素变化及变化在调脂干预对急性冠状动脉 (冠脉 )事件的冠脉粥样病变炎症反应的影响。方法 :用酶联免疫吸附法及硝酸还原酶比色法测定 30例健康对照组和 6 2例冠心病不稳定型心绞痛患者应用辛伐他汀治疗前后的血浆 P选择素、氧化修饰低密度脂蛋白 ( OX L DL )和血清一氧化氮 ( NO)水平。结果 :不稳定性心绞痛组血浆 P选择素、OX L DL水平较对照组明显增高 ,血清 NO水平明显减低 ;血浆 P选择素水平与血浆 OX L DL水平呈显著正相关 ,与血清 NO水平显著负相关 ;辛伐他汀治疗 6周后不稳定型心绞痛组血浆 P 选择素、OX L DL 水平明显降低 ,血清 NO水平明显回升。结论 :( 1)急性冠脉事件的确存在着冠脉粥样病变的炎症反应 ;( 2 )冠脉粥样病变炎症反应与脂质过氧化及内皮细胞功能失常共同参与了急性冠脉事件的发生发展过程 ;( 3)调脂干预可阻断冠脉粥样病变的炎症反应 。Objective:To study the relationship between plasma Pselectin and coronary arteriosclerotic lesions and the effects of intervention lipid lowering in the patients with unstable angina pectoris.Methods:The plasma Pselectin and oxidized low density lipoprotein (OXLDL) were measured by enzymelinked immunosorbent assay (ELISA) and serum nitric oxide (NO) was measured by colorimetric analysis method before and after treatment with simvastatin in 62 patients with unstable angina pectoris and 30 healthy controls.Results:(1) The patients with unstable angina pectoris had higher levels of plasma Pselectin and OXLDL,lower levels of serum NO compared with those of control subjects.(2) A direct positive correlation was observed between plasma Pselectin and OXLDL levels and a direct negative correlation between plasma Pselectin and NO levels in patients with unstable angina pectoris.(3) Administration of simvastatin (20 mg/d for 6 weeks) to patients with unstable angina pectoris significantly reduced plasma Pselection and OXLDL levels and significantly elevated serum NO level.Conclusions:The patients with unstable angina pectoris do have inflammatory reaction due to coronary arterisclerotic lesions.The development of the disease is closely related to plasma Pselection,OXLDL and serum NO levels,and it can be blocked by intervention therapy for lipid lowering.

关 键 词：不稳定型心胶痛 动脉粥样硬化 炎症 P-选择素 辛伐他汀 治疗 

分 类 号：R541.4[医药卫生—心血管疾病]