摘要
目的探讨瑞舒伐他汀对急性冠状动脉综合征病人血清白细胞介素-18(IL-18)、C-反应蛋白(CRP)的影响,从而进一步研究其抗炎机制,从而更好的指导临床,并监测其降脂效果。
方法选取在我院心内科住院并行冠脉造影术证实存在冠脉狭窄的不稳定型心绞痛病人30例,稳定型心绞痛病人20例,以20例健康人作为正常对照组,用酶联免疫吸附法(ELISA)测定其血IL-18,免疫比浊法测定C反应蛋白水平。不稳定型心绞痛和稳定型心绞痛病人入院空腹12小时后采血测定IL-18和CRP水平并记录不稳定型心绞痛患者血清甘油三酯、胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇。不稳定型心绞痛病人入院采血后每晚给予瑞舒伐他汀10mg,每日1次,共用药6周,记录其治疗后血脂水平,并测定血IL-18和CRP水平。
结果正常健康对照组、稳定型心绞痛组和不稳定型心绞痛组各组间的血清IL-18和CRP水平不同,差别有统计学意义(F=190.961,P<0.01;F=22.359,P<0.01),稳定型心绞痛组的血清IL-18和CRP高于正常健康对照组,不稳定型心绞痛组的血清IL-18和CRP高于稳定型心绞痛组。不稳定型心绞痛组给予瑞舒伐他汀治疗后血清胆固醇和低密度脂蛋白胆固醇水平明显下降,高密度脂蛋白胆固醇水平显著升高,差异有统计学意义(P<0.05),IL-18和CRP水平均明显下降,差异有统计学意义(t=12.553,P<0.01;t=7.991,P<0.01)。
结论(1)炎症是冠心病的发病机制之一,参与动脉粥样硬化病变的发生、发展,IL-18和CRP是反映冠脉粥样病变的炎症反应的重要指标,在斑块的不稳定性中发挥重要的作用。(2)瑞舒伐他汀除能降低急性冠状动脉综合征患者的血清胆固醇、低密度脂蛋白胆固醇水平,提高高密度脂蛋白胆固醇水平之外,并能显著降低其炎症反应,稳定斑块。
Objective To study effects of rosuvastatin on plasma intefleukin-18(IL-18) and C-creactive protein(CRP) levels in patients with acute coronary syndrome and to investigate the effects of rosuvastatin on decreasing blood lipid level.
Methods All patients with coronary heart disease were divided into two groups, including 30 cases of unstable angina group,20 cases of stable angina group,there were 20 cases in normal control group,levels of IL-18,CRP were detected.Unstable angina group was given rosuvastatin(10mg a day) every night for 6 weeks.Levels of TG,TC,HDL,LDL,IL- 18,CRP were measured before and after treatment.
Results The serum levels of IL-18 and CRP were distinctively different in the three groups(F=190.961,P<0.01;F:22.359,P<0.01).The serum levels of IL-18 and CRP on patients with coronary heart disease were much higher than nomal control',those in unstable angina group higher than in angina group.Levels of IL-18,CRP in unstable angina group were distinctively lower after treatment(t=12.553,P<0.01;t=7.991, P<0.01),and so as TC,LDL,and level of HDL advanced.
Conclusion IL-18 and CRP are the indexes for inflammation of atherosclerosis,it plays an important role in plaque stability.Rosuvastatin can decrease levels of serum TC,LDL,IL-18,CRP in patients with acute coronary syndrome and hoist HDL,reduce inflammation,stable plaque.
引文
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