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目的观察急性心肌梗死(AMI)患者分别使用不同剂量阿托伐他汀治疗后对血浆Ⅲ型前胶原肽(PⅢNP)和单核细胞趋化因子-1(MCP-1)水平的影响,探索阿托伐他汀影响AMI后心肌胶原增生的机制。方法入选204例急性心肌梗死患者,按照每天给予阿托伐他汀片的剂量将患者随机分为A1组(20 mg,每天1次,n=40),A2组(40 mg,每天1次,n=45)、A3组(80 mg,每天1次,n=39)和阳性对照组(P组,n=40)、另入选冠状动脉造影正常的健康人30例作为对照组(C组);用药前及用药后1、2、4周分别测定PⅢNP、MCP-1水平。结果用药2周后A1、A2和A3组PⅢNP、MCP-1水平较用药前有明显下降,其中A2组明显低于A1组(P<0.05),A3组明显低于A2组(P<0.05),A3组较A1组有显著下降(P<0.01);A1、A2、A3组和P组比较差异有统计学意义(P<0.01)。服药后2周A1、A2和A3组PⅢNP和MCP-1水平之间呈显著正相关(r分别为0.25、0.59和0.62,P<0.01)。结论阿托伐他汀能降低血脂正常急性心肌梗死患者血浆Ⅲ型前胶原肽和单核细胞趋化因子-1水平,且呈剂量依赖性。
Objective To investigate the effects of atorvastatin on plasma levels of type Ⅲ procollagen peptide (PⅢNP) and monocyte chemotactic factor-1 (MCP-1) in patients with acute myocardial infarction (AMI) Mechanism of the effects of statin on myocardial collagen hyperplasia after AMI. Methods Totally 204 patients with acute myocardial infarction were enrolled in this study. Patients were randomly divided into A1 group (20 mg once daily, n = 40), A2 group (40 mg once daily, n (N = 40, n = 40 in group A3), n = 39 in group A3 (80 mg once daily, n = 40 in group P), and 30 healthy subjects with normal coronary angiography were selected as control group. PⅢNP and MCP-1 levels were measured before treatment and at 1, 2, 4 weeks after treatment. Results The levels of PⅢNP and MCP-1 in A1, A2 and A3 groups were significantly lower than those before A1P2 treatment in A2, A3 group (P <0.05), while those in A3 group were significantly lower than those in A2 group (P <0.05) (P <0.01). There was a significant difference between A1, A2, A3 and P groups (P <0.01). There was a significant positive correlation between PⅢNP and MCP-1 levels in A1, A2 and A3 groups (r = 0.25, 0.59 and 0.62 respectively, P <0.01) at 2 weeks after treatment. Conclusions Atorvastatin can reduce the plasma level of procollagen Ⅲ and monocyte chemotactic factor-1 in patients with normal blood lipids in a dose-dependent manner.