论文部分内容阅读
目的探讨不同调脂方案对冠心病患者细胞间黏附分子-1(ICAM-1)、血管细胞黏附分子-1(VCAM-1)和单核细胞趋化蛋白-1(MCP-1)的影响。方法选取冠状动脉狭窄50%～70%的冠心病患者42例,均不植入支架,分为单用他汀组(n=19)和联合治疗组(n=23)。单用他汀组患者第1～4周服用阿托伐他汀20 mg,第5～12周服用阿托伐他汀40 mg;联合治疗组第1～4周服用阿托伐他汀5 mg+依折麦布10 mg,第5～12周服用阿托伐他汀10 mg+依折麦布10 mg。分别在治疗前、治疗后第4周和12周抽取患者静脉血,测定血脂、肝肾功能、肌酸激酶以及ICAM-1、VCAM-1、MCP-1浓度。结果①单用他汀组和联合治疗组患者治疗后第4周TC和LDL-C浓度均明显下降,第12周时分别较治疗前下降37.82%和38.26%,与治疗前比较差异均有统计学意义(P<0.01);但组间比较差异无统计学意义(P>0.05)。②两组患者肝肾功能和磷酸肌酸激酶在治疗后均无明显升高。③单用他汀组在治疗后第12周时ICAM-1、VCAM-1和MCP-1水平明显降低,与治疗前比较差异有统计学意义(P<0.05);与联合治疗组比较差异也有统计学意义(P<0.05)。结论单用较大剂量他汀对冠状动脉狭窄50%～70%的冠心病患者的斑块稳定性作用可能优于小剂量他汀和依折麦布的联合治疗。
Objective To investigate the effects of different lipid-lowering regimens on the expression of ICAM-1, VCAM-1 and MCP-1 in patients with coronary heart disease. Methods Forty-two patients with coronary heart disease (50% -70%) with coronary artery stenosis were enrolled in the study. Patients were divided into two groups: statin group (n = 19) and combination group (n = 23). Patients in the statin group were randomized to receive atorvastatin 20 mg for weeks 1-4 and atorvastatin 40 mg for weeks 5 to 12. Patients in the cohort were randomized to receive atorvastatin 5 mg + 10 mg, taking atorvastatin 10 mg + ezetimibe 10 mg for weeks 5-12. Venous blood samples were collected before treatment, 4 weeks and 12 weeks after treatment, and the levels of serum lipids, liver and kidney function, creatine kinase, ICAM-1, VCAM-1 and MCP-1 were measured. Results ① The levels of TC and LDL-C in the 4th week after treatment were significantly decreased in the statin group and the combination therapy group, and decreased by 37.82% and 38.26% respectively at the 12th week, compared with those before treatment (P <0.01), but there was no significant difference between the two groups (P> 0.05). ② The liver and kidney function and creatine phosphokinase in both groups had no significant increase after treatment. (3) The levels of ICAM-1, VCAM-1 and MCP-1 in the statin group decreased significantly at the 12th week after treatment compared with that before treatment (P <0.05); the difference was statistically significant compared with the combination therapy group Significance (P <0.05). Conclusions The plaque stability of patients with coronary heart disease with coronary stenosis of 50% ~ 70% may be better than that of low-dose statin and ezetimibe by single-dose statin.