【摘要】 目的:探讨强化剂量阿托伐他汀对不稳定型心绞痛患者经皮冠状动脉介入术(PCI)围手术期炎症反应的影响。方法:选取2012年10月至2014年10月广西中医药大学第一附属医院和广西医科大学第一附属医院心内科收治的不稳定型心绞痛患者80例,均采用PCI治疗,根据PCI围手术期阿托伐他汀用药剂量不同将其分为常规剂量组和强化剂量组,每组40例。采用酶联免疫吸附试验(ELISA)方法检测两组患者PCI术前及术后血清可溶性B7-H3(sB7-H3)、白介素(IL)-4、IL-10及γ干扰素(IFN-γ)水平,荧光定量PCR(FQ-PCR)法检测外周血单核细胞(PBMC)B7-H3mRNA相对表达量。结果:两组患者PCI术后IL-10、sB7-H3水平和B7-H3mRNA相对表达量均较术前升高,其中强化剂量组升高更为显著(P<0.05)。两组患者PCI术后的IL-4、IFN-γ水平均较术前降低,且强化剂量组较常规剂量组下降更为明显(P<0.05)。Spearman相关性分析结果显示,PBMC B7-H3与IL-10水平呈正相关关系(r=0.629,P<0.05);PBMC B7-H3与IL-4、IFN-γ水平均呈负相关关系(r=-0.342、-0.417,均P<0.05)。结论:强化剂量阿托伐他汀可能通过上调B7-H3表达,调节炎性因子IL-10、IL-4、IFN-γ水平,从而抑制不稳定型心绞痛患者PCI术后炎症反应。更多还原

【Abstract】 Objective:To investigate the intensive atorvastatin therapy on inflammatory response in patients with unstable angina pectoris(UAP)during perioperative period of percutaneous coronary intervention(PCI).Methods:80UAP patients were selected and divided into a conventional-dose group and a high-dose group according to doses of atorvastatin administrated in patients during perioperative period of PCI.The serum soluble B7-H3(sB7-H3),interleukin(IL)-4,IL-10 and interferon-γ(IFN-γ)levels were measured by enzyme-linked immunosorbent assay(ELISA)before and after PCI.Peripheral blood monouclear cells(PMBCs)were collected and the B7-H3 mRNA level was determined by fluorescence quantitative PCR(FQ-PCR).Results:After PCI,the serum IL-10 and sB7-H3 levels and B7-H3 mRNA expression were elevated,whereas the IL-4 and IFN-γlevels were reduced in both groups,and the reduction was more significant in the high-dose group(P <0.05).Spearman correlation analysis revealed that the B7-H3 mRNA level in PMBCs was positively associated with the serum IL-10level(r =0.629,P <0.05),and was negatively associated with the serum IL-4and IFN-γlevels(r =-0.342,-0.417;P <0.05).Conclusion:The intensive atorvastatin treatment could inhibit postoperative inflammatory response in UAP patients underwent PCI via elevating B7-H3 mRNA expression and regulating IL-10,IL-4and IFN-γlevels.更多还原