不同ARB类药物对CHD患者的抗炎、调脂水平的差异性探究
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摘要
目的:探讨临床上常用ARB类药物对冠心病(Coronary heart disease,CHD)患者的抗炎及调脂水平差异。方法:入选确诊冠心病(CHD)患者135例,随机分为缬沙坦组、厄贝沙坦组及替米沙坦组,观察各组治疗前及治疗1个月后的血浆Cox-2、TNF-a及胆固醇(TC)及甘油三酯(TG)水平。结果:缬沙坦及替米沙坦组治疗前后的炎症因子Cox-2、TNF-a水平表达具有统计学差异(P<0.05)。厄贝沙坦组治疗前后的炎症因子Cox-2水平表达具有统计学差异(P<0.05),但TNF-a水平表达无统计学差异。缬沙坦组治疗前后的TC、TG水平表达具有统计学差异(P<0.05)。厄贝沙坦组及替米沙坦组治疗前后的TC水平表达具有统计学差异(P<0.05),但TG水平无统计学差异。结论:缬沙坦、厄贝沙坦及替米沙坦均在一定程度上具有减少炎症因子释放,降低血脂(包括TC、TG)水平的作用,但各具特点。
Objective:To investigate the anti-inflammatory and lipid regulating effects of Angiotensin Receptor Blocker(ARB) drugs commonly used in clinical practice on coronary heart disease. Methods: A total of 135 patients with coronary heart disease(CHD) were randomly divided into valsartan group, irbesartan group and telmisartan group. The levels of plasma Cox-2, TNF-a, cholesterol and triglyceride were observed before treatment and one months after treatment. Results: There were significant differences in the levels of inflammatory factors Cox-2 and TNF-a before and after treatment in valsartan and telmisartan groups(P<0.05). There was significant difference in the level of inflammatory factor Cox-2 before and after treatment in irbesartan group(P<0.05), but there was no significant difference in the expression of TNF-a. The expression of TC and TG in valsartan group before and after treatment had statistical difference(P<0.05). There was significant difference in the level of TC between irbesartan group and telmisartan group before and after treatment(P<0.05), but there was no significant difference in TG level between the two groups. Conclusion: Valsartan, irbesartan and telmisartan can reduce the release of inflammatory factors and decrease the levels of lipids(including TC and TG) to some extent, but each has its own characteristics.
Objective:To investigate the anti-inflammatory and lipid regulating effects of Angiotensin Receptor Blocker(ARB) drugs commonly used in clinical practice on coronary heart disease. Methods: A total of 135 patients with coronary heart disease(CHD) were randomly divided into valsartan group, irbesartan group and telmisartan group. The levels of plasma Cox-2, TNF-a, cholesterol and triglyceride were observed before treatment and one months after treatment. Results: There were significant differences in the levels of inflammatory factors Cox-2 and TNF-a before and after treatment in valsartan and telmisartan groups(P<0.05). There was significant difference in the level of inflammatory factor Cox-2 before and after treatment in irbesartan group(P<0.05), but there was no significant difference in the expression of TNF-a. The expression of TC and TG in valsartan group before and after treatment had statistical difference(P<0.05). There was significant difference in the level of TC between irbesartan group and telmisartan group before and after treatment(P<0.05), but there was no significant difference in TG level between the two groups. Conclusion: Valsartan, irbesartan and telmisartan can reduce the release of inflammatory factors and decrease the levels of lipids(including TC and TG) to some extent, but each has its own characteristics.
引文
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[4] Schonbeck U, Sukhova GK, Graber P, et al. Augmented expression of cycloxygenase-2 in human atherosclerotic lesions[J].Am J pathol,1999 ,155 (4):1281-291.
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[7] 李如君,龚开政,张振刚.蛋白质氧连糖基化修饰对肿瘤坏死因子a诱导的小鼠心肌成纤维细胞增殖的影响[J].中华高血压杂志,2017,25(4):370-376.
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[9] 孙少卫,童文娟. 动脉粥样硬化的中西医观[J].中国动脉硬化杂志,2016,5(24):524-528.
[10] 周吉利,钟江华.冠心病合并高脂血症患者血脂水平对主要炎症因子表达的相关性分析[J].中国实验诊断学,2011,10(15):1696-1698.
[2] Aoyama T, Minatoguchi S. The effect of ARB on prevention of atherosclerosis[J].Nihon Rinsho,2011,69(1):92-99.
[3] 黄春艳,李荣亨.几种血管紧张素Ⅱ受体拮抗药抗动脉粥样硬化的效应特点[J].中国药房,2015,10(26):1400-1402.
[4] Schonbeck U, Sukhova GK, Graber P, et al. Augmented expression of cycloxygenase-2 in human atherosclerotic lesions[J].Am J pathol,1999 ,155 (4):1281-291.
[5] Burleigh ME, Babaev VR, Oates JA, et al. Cycloxygenase-2 promotes early atherosclerotic lesion formation in LDL receptor-deficientmic[J].Circulation,2002,105 (15):1816-1823.
[6] McGeer PL, McGeer EG, Yasojima K. Expression of Cox-1 and Cox-2 mRNAs in atherosclerotic plaques[J].Exp Gerontol,2002,37(7):925-929.
[7] 李如君,龚开政,张振刚.蛋白质氧连糖基化修饰对肿瘤坏死因子a诱导的小鼠心肌成纤维细胞增殖的影响[J].中华高血压杂志,2017,25(4):370-376.
[8] 何东,李骊华.脂联素与抵抗素对动脉粥样硬化的作用及其与血管紧张素受体拮抗剂关系[J].中国老年学杂志,2014,4(34):1142-1144.
[9] 孙少卫,童文娟. 动脉粥样硬化的中西医观[J].中国动脉硬化杂志,2016,5(24):524-528.
[10] 周吉利,钟江华.冠心病合并高脂血症患者血脂水平对主要炎症因子表达的相关性分析[J].中国实验诊断学,2011,10(15):1696-1698.