慢性心衰患者单核细胞趋化蛋白-1的表达及阿托伐他汀对其的影响

Regulation of atorvastatin on the expression of monocyte chemotactic protein-1 in patients with chronic heart failure

目的测定单核细胞趋化蛋白-1(monocyte chemotactic protein-1,MCP-1)在慢性心力衰竭(心衰,CHF)患者中的表达改变,及羟甲基戊二酰辅酶A(3-hy-Droxyl-3-methylglutarylcoenzymeA,HMG-CoA)还原酶抑制剂阿托伐他汀对其的调节作用,探讨MCP-1在心衰发病中可能发生的作用及阿托伐他汀在心衰中的保护机制。方法采用酶联免疫吸附法测定65例CHF患者和20例正常人(正常对照组)血浆中单核细胞趋化蛋白-l(MCP-1)的浓度,心脏彩超评价心脏结构及功能。并将慢性心衰患者分为常规治疗组(31例)和阿托伐他汀治疗组(34例),共观察12周。结果CHF组血浆中MCP-1较正常对照组明显升高(P<0.01)。与心衰对照组比较,阿托伐他汀组的LVEDD、E/A、MCP-1均显著降低(均P<0.05),FS和LVEF显著升高(均P<0.05)。结论外周血浆中MCP-1水平的升高是心衰时机体免疫激活的一个标志,阿托伐他汀可改善心功能、抑制炎症反应。

Objective To investigate the expression of monocyte chemotactic protein-1 （PCP-1） in patients with chronic heart failure （CHF） and it＇s modulation by atorvastatin and explore the role of MCP-1 and the protective mechanism of atorvastatin in the pathogenesis of chronic heart failure. Methods Patients with CHF were randomized to receive routine therapy （n=31） or atorvastatin in addition to routine therapy （n= 34） for 12 weeks, Their MCP-1 levels were evaluated before and after treatment. The function and structure of the heart were evaluated by ultrasonic cardiogram. Results ①The plasm MCP-1 levels of both CHF groups were higher than those of the normal control group （p〈0.01）. ②In comparison with CHF control group, The plasm MCP-1 level, LVEDD, E/A were all significantly decreased （all P〈0.05）, while FS and LVEF were significantly increased in atorvastatin group （both P〈0.05）. Conclusion The high plasm levd of MCP-1 in patients with CHF might be a marker of immune activation. Atorvastatin can improve heart function and inhibit inflammatory respanse.