不同剂量阿托伐他汀对急性冠脉综合征患者HO-1/HbCO系统、血清sOX40L水平影响及其与炎性因子的相关性分析  

Effect of different doses of atorvastatin on HO-1/HbCO system and plasma sOX40L level in patients with acute coronary syndrome and its correlation with inflammatory factors

作　　者：张驰 王丽岳 任浩进 龚凡 朱晓刚 徐超[1] factors ZHANG Chi;WANG Liyue;REN Haojin;GONG Fan;ZHU Xiao gang;XU Chao(Department of Cardiology,Puren Hospital Affiliated to Wuhan University of Science and Technology,Wuhan 430081,China)

机构地区：[1]武汉科技大学附属普仁医院心内科,430081

出　　处：《疑难病杂志》2019年第5期437-441,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：武汉市卫生局临床医学科研项目(WX12D01)

摘　　要：目的观察不同剂量阿托伐他汀对急性冠状动脉综合征(ACS)患者血红素氧合酶-1/一氧化碳(HO-1/HbCO)系统、血清可溶性OX40L(sOX40L.)水平以及炎性因子的影响,分析HO-1/HbCO系统、sOX40L水平与炎性因子的相关性。方法选择2016年5月—2018年5月武汉科技大学附属普仁医院心内科收治ACS患者96例作为研究对象,按照随机数字法分为对照组和观察组,各48例。在常规治疗基础上,对照组患者给予阿托伐他汀20 mg/d治疗,观察组患者给予阿托伐他汀40 mg/d治疗,比较2组患者治疗前后血清sOX40L、HO-1、HbCO以及相关炎性细胞因子水平变化,采用Pearson法分析CRP、IL-6与HO-1/HbCO系统、sOX40L水平的相关性。结果与治疗前比较,2组患者治疗后sOX40L水平均明显降低,HO-1、HbCO水平均明显升高,且观察组降低/升高较对照组为更显著(t/P=4.537/0.000, 6. 154/0.000,8.236/0.000;CRP、IL-6、TC、LDL-C水平均明显降低(t/P=3.405/0. 000,12. 252/0. 000,6.263/0.000,9.777/0.000)。sOX40L水平与CRP、IL-6水平呈正相关(r/P=0.781/0.005,0. 537/0.014), HO-1、HbCO水平与CRP、IL-6水平呈负相关(r/P=-0.217/0.017,-0.359/0.001,-0.189/0.031,-0.523/0.000)。结论大剂量阿托伐他汀治疗急性冠状动脉综合征患者效果更佳,其血清CRP、IL-6水平与sOX40L水平呈正相关,与HO-1以及HbCO水平呈负相关,具有一定的临床应用价值。Objective To observe the effects of different doses of atorvastatin on the levels of heme oxygenase-1/carbon monoxide(HO-1/HbCO), plasma soluble OX40 L(sOX40 L) and inflammatory factors in patients with acute coronary syndrome(ACS), and to analyze the correlation between HO-1/HbCO system, sOX40 L and inflammatory factors. Methods From May 2016 to May 2018, 96 patients with ACS admitted to the Department of Cardiology, Puren Hospital Affiliated to Wuhan University of Science and Technology were selected as the study subjects. They were randomly divided into control group and observation group, 48 cases in each group. On the basis of routine treatment, patients in the control group were treated with atorvastatin 20 mg/d, while patients in the observation group were treated with atorvastatin 40 mg/d. The changes of blood lipid, HO-1,HbCO and related inflammatory cytokines were compared between the two groups before and after treatment. The correlation between CRP, IL-6, HO-1/HbCO system and sOX40 L level was analyzed by Pearson method. Results Compared with before treatment, after treatment, the sOX40 L levels in the two groups were significantly decreased, HO-1 and HbCO levels were significantly increased, and the decrease/increased in the observation group was more significant than that in the control group(t/P=4.537/0.000, t/P=6.154/0.000,t/P = 8.236/0.000). The levels of CRP, IL-6, TC,and LDL-C were significantly lower(t/P = 3.405/0.000, t/P = 12.252/0.000, t/P = 6.263/0.000, t/P = 9.777/0. 000). The level of sOX40 L was positively correlated with CRP and IL-6 levels( r/P = 0. 781/0. 005,r/P =0. 537/0. 014),and HO-1 and HbCO levels were negatively correlated with CRP and IL-6 levels(r/P =-0. 217/0. 0\1,r/P =-0. 359/0.001,r/P=-0. 189/0. 031, r/P =-0. 523/0. 000). Conclusion High-dose atorvastatin is more effective in the treatment of acute coronary syndrome. Serum CRP and IL-6 levels are positively correlated with sOX40 L levels and negatively correlated with HO-1 and HbCO levels. It has certain clinical value.

关 键 词：阿托伐他汀 急性冠状动脉综合征 HO-1/HbCO系统 可溶性OX40L C-反应蛋白 白介素-6 相关性 

分 类 号：R541.4[医药卫生—心血管疾病]