强化阿托伐他汀治疗对PCI患者EMPs、Th17/Treg水平及Notch1信号通路的影响  

Effect of intensive atorvastatin on endothelial micparticles,Th17/Treg and Notch1 signaling pathways in patients with acute coronary syndrome undergoing percutaneous coronary intervention

作　　者：陈园月 陆永光[1] 陈丽媛[1] 黄军章[1] 陈林[1] 仇昌智[1] CHEN Yuan-yue;LU Yong-guang;CHEN Li-yuan(Department of Cardiology,Qinzhou Second People's Hospital,Qinzhou 535099,China)

机构地区：[1]钦州市第二人民医院心内科,广西钦州535099

出　　处：《吉林医学》2022年第7期1733-1736,共4页Jilin Medical Journal

基　　金：广西壮族自治区自然科学基金项目[项目编号:2012GXNSFBA053113];广西壮族自治区卫计委自筹经费科研课题[项目编号:Z2016061];钦州市科技计划项目[项目编号:20164419]。

摘　　要：目的:探讨强化剂量阿托伐他汀治疗对急性冠状动脉综合征(ACS)行经皮冠状动脉介入治疗(PCI)患者外周血EMPs水平和Th17/Treg及细胞因子水平的影响。方法:选取行PCI的ACS患者112例为研究对象,根据治疗方法分为阿托伐他汀强化治疗组(强化组)和阿托伐他汀常规治疗组(常规组)各56例。常规组PCI前后服用阿托伐他汀20 mg/d,强化组PCI前口服阿托伐他汀80 mg/d,手术后40 mg/d。分别于术前、术后1周采用流式细胞仪检测EMPs、Th17及Treg数目;RT-PCR法检测ROR-yt、Foxp3及Notch1 mRNA表达;ELISA法检测IL-17。采用直线相关分析探讨EMPs与ROR-yt mRNA和IL-17及Notch1 mRNA的相关性。结果:与本组治疗前及常规组治疗后比较,治疗后强化组Th17、IL-17水平、ROR-yt mRNA及Notch1-mRNA表达量均有所降低,Treg及Treg/Th17、Foxp3 mRNA表达量均有所升高,EMPs水平低于术前且强化组较常规组变化更明显,差异均有统计学意义(均P<0.01)。EMPs与ROR-yt mRNA和IL-17及Notch1 mRNA水平均呈正相关。结论:EMPs可能参与ACS患者Th17/Treg失衡的调控,强化阿托伐他汀用药可在一定程度上通过下调EMPs水平,纠正Th17/Treg失衡及抑制Notch1表达,从而减轻炎性反应。Objective To investigate the effects of intensive atorvastatin on endothelial micparticles(EMPs),Th17/Treg as well as cytokine level in patients with acute coronary syndrome(ACS)undergoing percutaneous coronary intervention(PCI).Method A total of 112 ACS patients Undergoing PCI were selected and divided into intensive atorvastatin treatment group(intensive group)and conventional atorvastatin treatment group(conventional group)according to the different treatment methods,with 56 patients in each group.Conventional group received atorvastatin 20 mg/d before and after PCI,and intensive group received atorvastatin 80 mg/d before PCI and 40 mg/d after PCI.The levels of EMPs,Th17/Treg,number of Treg were detected before PCI and one week after PCI in both groups,and the relationship of EMPs with ROR-yt mRNA,IL-17 and Notch 1 mRNA were analyzed.The number of Th17,Treg and EMPs were measured by flow cytometry,and Th17,Treg ratios and EMPs were calculated.RT-PCR was used to detect the expression of Retinoic acid-related orphan nuclear receptor(ROR-yt)mRNA in Th17 cell-specific transcription factor,Foxp3 mRNA expression in Treg cell-specific transcription factor,and Notch1 mRNA expression;ELISA detection of IL-17.Results After treatment,the Th17 ratio,relative plasma ROR-yt mRNA expression,serum IL-17 and Notch1-mRNA in atorvastatin group were lower than those before treatment and conventional treatment group.The relative expression levels of Treg and Treg/Th17,Foxp3 mRNA were higher than that before treatment and after treatment in the conventional treatment group.The EMPs level was lower than before and the intensive group had more significant changes than the conventional group(P<0.01).EMPs and ROR-yt mRNA,IL-17 and Notch1 mRNA levels were positively correlated,but EMPs were negatively correlated with Foxp3 mRNA levels.Conclusion The presence of Th17/Treg imbalance in patients with acute coronary syndrome is involved in the development of acute coronary syndrome.EMPs are positively correlated with Notch1 mRNA,ROR-yt mRNA

关 键 词：急性冠脉综合征 阿托伐他汀 内皮细胞微粒 Notch1信号通路 

分 类 号：R541.4[医药卫生—心血管疾病]