阿托伐他汀对高脂血症患者补体调节蛋白CD55、CD59表达的影响

The effect of atorvastatin on the expression of CD55,CD59 in patients with hyperlipidemia

目的观察高脂血症患者补体调节蛋白CD55、CD59的表达及其与补体活化、脂代谢紊乱之间的关系,并探讨阿托伐他汀对其的影响.方法高脂血症患者67例,年龄、性别、体重与其匹配的健康对照24例,使用流式细胞仪测定外周血白细胞CD55、CD59的表达,分析CD55、CD59表达水平与血脂、补体活化指标、炎症因子及相关临床指标间的关系,对其中24例高脂血症患者使用阿托伐他汀治疗8～12周,观察治疗前后CD55、CD59表达的变化.结果高脂血症患者CD55阳性淋巴细胞、单核细胞平均荧光强度(MFI)低于健康对照组(2.07±0.28 比2.29±0.44及3.45±1.02 比4.33±2.32,P<0.01及P<0.05),CD55阳性淋巴细胞MFI与腰围、腰臀比值、高敏C反应蛋白、补体C5a呈负相关,与血脂不相关;补体C5a 水平与CD55阳性淋巴细胞、单核细胞、粒细胞MFI负相关,与TG和舒张压正相关,与CD59表达指标不相关;阿托伐他汀治疗后CD59阳性淋巴细胞、单核细胞、粒细胞MFI增加(4.34±1.16比3.69±0.76,4.52±1.36比3.91±0.89,5.67±1.72比4.56±1.03,P<0.05,P<0.05及P<0.01),与血脂变化不相关.结论高脂血症患者补体调节蛋白CD55表达下调,可能与肥胖、腹型脂肪分布、炎症状态有关,不受血脂的直接影响;CD55表达水平与补体活化有关;阿托伐他汀干预可使CD59表达上调,与调脂作用无关.

Objective To study the expressions of CD55 and CD59 in patients with hyperlipidemia and the effects of atorvastatin on it, and to identify the possible influential factors. Methods We selected 67 patients with hyperlipidemia, and 24 healthy people matched in terms of age, sex and body weight as control. The expressions of CD55 and CD59 on white blood cells were detected by flow cytometry, and their relationships to blood lipids, complement activation indexes （C5a, sC5b-9 ）, inflammatory factors （high sensitivity C-reactive protein （hsCRP） , TNF-α, IL-6 were analyzed. 24 patients with hyperlipidemia were treated with atorvastatin for 8-12 weeks and the expressions of CD55 and CD59 were measured before and after atorvastatin therapy. Results The mean fluorescence intensity （ MFI ） of CD55 lymphocytes and monocytes were decreased in patients with hyperlipidemia compared with control （ 2.07 ± 0.28 vs 2.29 ± 0. 44 and 3.45 ± 1.02 vs 4. 33 ± 2. 32, P 〈 0. 01 and P 〈 0. 05, respectively）. CD55 positive lymphocyte MFI was negatively correlated with waist circumference, waist-hip ratio, hsCRP and C5a. C5a was negatively correlated with the MFIs of CD55 positive lymphocytes, monoeytes, granulocytes, and positively with TG and diastolic blood pressure. After atorvastatin therapy, the MFIs of CD59 positive lymphocytes, monocytes and granulocytes increased （4. 34 ± 1.16 vs 3.69 ± 0. 76,4. 52 ± 1.36 vs 3.91 ± 0. 89,5.67 ± 1.72 vs 4. 56 ± 1.03, P 〈 0. 05, 〈 0. 05 and 〈 0.01 respectively）, which were not correlated with changes of blood lipids. Condusions The expression of CD55 is down-regulated in hyperlipidemia, which might be influenced by obesity, abdominal distribution of adipose tissue and inflammatory status of hyperlipidemia, but not by blood lipids. The expression of CD55 is related with complement activation; The expression of CD59 is up-regulated after atorvastatin treatment independently of blood lipids.