急性冠状动脉综合征患者sCD40L的变化及他汀类药物的影响

Effect of Simvastatin or Pravastatin on soluble CD40L levels in patients with acute coronary syndrome

目的探讨急性冠状动脉综合征(ACS)患者血清可溶性CD40L(sCD40L)水平的变化及他汀类药物对其的影响。方法102例ACS患者随机分为2组:安慰剂组,辛伐他汀和普伐他汀组(他汀组)。用间接免疫荧光流式细胞术和酶联免疫吸附法(ELISA)及常规酶法分别测定2组患者用药前和用药2、4、6周后血清sCD40L水平及总胆固醇(TC)水平。结果(1)他汀组患者服药2,4及6周后血清sCD40L水平明显低于安慰剂组(均P<0.05)。(2)他汀组患者服药2、4、6周后血清sCD40L水平呈逐渐下降趋势,同用药前相比差异均有统计学意义(均P<0.05)。(3)他汀组患者服药2、4、6周后血浆TC水平与用药前相比差异均有统计学意义(均P<0.05)。(4)他汀组患者血清sCD40L水平的降低与血浆TC水平的降低无明显相关性(r=0.014,P>0.05)。结论他汀类药物能明显降低ACS患者体内sCD40L水平,对减轻炎症反应、稳定斑块有一定作用。

Objective To investigate the effect of simvastatin or pravastatin on serum soluble CD40L （sCD40L） levels in patients with acute coronary syndrome （ACS）. Methods One hundred and two cases with ACS were randomly divided into 2 groups： Group A （placebo）, Group B （treated with simvastatin or pravastatin）. Serum sCD40L levels and total cholesterol （TC） were measured by enzyme linked immunosorbent assay（ELISA）and enzyme assay respectively. Results Serum sCD40L levels of group B were significantly lower than those of group A after treated for 2, 4 and 6 weeks＇（ all P〈0.05）. After 2, 4 and 6 weeks＇ treatment in Group B, sCD40L levels were markedly decreased compared to those before treatment （all P 〈 0.05 ）; Plasma TC levels were also considerably lower than before （all P〈0.05）. There were no significant correlation between the decrease of sCD40L levels and the reduction TC levels in group B （r = 0. 014, P 〈 0.05）. Conclusions Both simvastatin and pravastatin can reduce the level of sCD40L in ACS patients, which may benefit to the stabilization of atherosclerotie plaque.