【摘要】 目的验证OX40L在冠心病患者及正常对照血浆中的变化,探讨不同剂量阿托伐他汀早期干预治疗对急性冠脉综合症(ACS)患者血浆炎症指标OX40L及超敏C反应蛋白(hs-CRP)水平的影响。方法急性冠脉综合症(ACS)60例,稳定型心绞痛20例(SA),非冠心病患者20例(C)。分别测定以上各组患者入院时的血浆OX40L及hs-CRP水平。将ACS患者随机分成阿托伐他汀10mg/d组(A组)和40mg/d组(B组),疗程均为7～10d,第8d测定两组ACS患者血浆OX40L及超敏CRP的水平。结果⑴ACS组血浆OX40L水平高于正常组(P<0.05),略高于SA组,差异无统计学意义。三组hs-CRP水平比较,ACS组明显高于正常组和SA组(P<0.05);⑵阿托伐他汀治疗1周后A、B两组血浆OX40L及hs-CRP水平均有所下降,A组患者血浆hs-CRP水平治疗前后差异有统计学意义(P<0.05),OX40L治疗前后差异无统计学意义,B组hs-CRP及OX40L治疗前后均有统计学意义。将A、B两组治疗前后的变化值进行比较,OX40L与hs-CRP降低幅度均有差别,且差别有统计学意义(P<0.05),B组较A组作用更明显。⑶ACS患者血浆OX40L与hs-CRP之间呈正相关(r=0.52,P<0.001)。结论 ACS患者血浆OX40L、hs-CRP水平增高,早期阿托伐他汀治疗可降低ACS患者OX40L及hs-CRP水平,且不同剂量阿托伐他汀对于OX40L、hs-CRP会产生不同的影响,40mg/d抗炎作用强于10mg/d,ACS患者早期应用大剂量的他汀类强化治疗可能使患者获益更大。更多还原

【Abstract】 Objective To investigate the effect of early atorvastatin therapy in different dosages on plasma OX40L and hs-CRP in patients with acute coronary syndrome(ACS).Methods Plasma concentration of OX40L and hs-CRP of 60 ACS patients were measured before treatments after admission as well as 20 stable angina pectoris(SA)patients and 20 patients without coronary heart disease as control(C) group.After that,60 ACS patients were divided randomly into two groups,one group treated with 10mg/d atorvastatin as A group,while another treated with 40mg/d atorvastatin as B group.The use of atorvastatin lasted from seven to ten days.Plasma OX40L and hs-CRP concentration were measured again in these patients after treatment.Results ①The plasma concentration of OX40L and hsCRP in ACS patients were significantly higher than control group(P<0.05).②The concentration of OX40L and hsCRP after the atorvastatin intervene were decreased in both A and B group.Levels of plasma OX40L in A group are lower,but there is no significantly difference(P>0.05).In B group,which were much lower than before atorvastatin intervene(P<0.05).Levels of plasma hsCRP had significant decreased in both A and B group(P<0.05).There were a much stronger OX40L and hsCRP decrease in patients taking 40mg/d atorvastatin than in A group(P<0.05).③And there was a positive correlation between OX40L and hsCRP in ACS patients(r=0.52,P<0.001).Conclusion The plasma concentration of OX40L and hsCRP in ACS patients were significantly higher than control group,The plasma concentration of OX40L and hsCRP decreased ofter short term atorvastatin treatment.It is proved in our study that Atorvastatin has a much more significant plasma concentration of OX40L and hsCRP decrease at 40mg/d than at 10mg/d.Therefore we suggest that all ACS patients should take atorvastatin at larger dosage as early as possible.更多还原