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目的研究急性冠状动脉综合征(ACS)患者IGF轴的改变及阿托伐他汀干预的影响。方法将70例ACS作为实验组;健康成年人68例作为对照组。治疗前各组在性别、年龄、心功能分级均无显著差异。ACS患者均予以阿托伐他汀(立普妥)20 mg/d治疗2周。分别于药物治疗前、治疗后2周采空腹静脉血,测定CK-MB、cTnI、PAPP-A、IGF-1、IGF-BP4、hs-CRP等指标;同时分离静脉血单核细胞,测定其IGF-1R基因mRNA表达量。结果 ACS患者组较健康成人对照组CK-MB、cTnI、hs-CRP、PAPP-A、IGF-1、IGF-BP4等指标均有显著差异(P<0.05),其中cTnI与hs-CRP差异极显著(P<0.01)。他汀治疗2周后,ACS患者血浆cTnI、CK-MB和hs-CRP浓度较治疗前明显降低(P<0.05),但与正常对照组相比仍有显著差异(P<0.05);治疗后PAPP-A与IGF-1均下降到正常对照组水平,但IGFBP-4水平较治疗前进一步上升(P<0.05);ACS患者治疗前、后单核细胞IGF-1R基因mRNA表达量均显著高于对照组(P<0.05)。结论 ACS患者血清IGF-1与IGFBP-4上升,阿托伐他汀可降低cTnI、CK-MB、hs-CRP、PAPP-A和IGF-1,增加IGFBP-4水平,但对IGF-1R表达无明显影响。
Objective To investigate the changes of IGF axis in patients with acute coronary syndrome (ACS) and the effects of atorvastatin intervention. Methods 70 cases of ACS as the experimental group; 68 healthy adults as a control group. Before treatment, there was no significant difference in gender, age and heart function grading in each group. ACS patients were treated with atorvastatin (Lipitor) 20 mg / d for 2 weeks. The levels of CK-MB, cTnI, PAPP-A, IGF-1, IGF-BP4 and hs-CRP were measured before drug treatment and 2 weeks after treatment. Venous blood mononuclear cells IGF-1R gene mRNA expression. Results There were significant differences in CK-MB, cTnI, hs-CRP, PAPP-A, IGF-1 and IGF-BP4 between ACS patients and healthy adults (P <0.05) Significant (P <0.01). Serum levels of cTnI, CK-MB and hs-CRP in patients with ACS were significantly lower than those before treatment (P <0.05) after 2 weeks of statin treatment, but still significantly different from those in normal controls (P <0.05) (P <0.05). The mRNA expression of IGF-1R in mononuclear cells in ACS patients before and after treatment was significantly higher than that in the control group Control group (P <0.05). Conclusions Serum levels of IGF-1 and IGFBP-4 are increased in ACS patients. Atorvastatin can reduce cTnI, CK-MB, hs-CRP, PAPP-A and IGF-1 and increase IGFBP- Clearly affected.