阿托伐他汀干预对急性冠状动脉综合征患者PCI术后粘附分子水平的影响

The effects of Atorvastatin intervention on adhesion molecule level in patients with acute coronary syndrome after PCI

目的探讨不同剂量阿托伐他汀治疗对ACS（急性冠状动脉综合征）患者急诊经皮冠状动脉介入治疗（PCI）术后粘附分子水平的影响。方法入选88例ACS患者随机分为：A常规治疗组30人，B阿托伐他汀标准剂量组29人，C阿托伐他汀负荷剂量组29人。三组分别于术前、术后3、7、14天抽血，用ELISA法测定血清可溶性细胞间粘附分子（soluble intercellular adhesionmolecule-1，sICAM-1）、血管细胞粘附分子（soluble vascular cell adhesion molecule-1，sVCAM-1）水平。结果阿托伐他汀80mg，d组在治疗第7天，两种血清粘附分子水平显著低于阿托伐他汀10mg／d组，两组sICAM-1分别是（68．35±23．80）μg／L和（131．45±29．12）μg／L、sVCAM-1分别是（251．65±36．61）μg／L和（334．87±32．98）μg／L。此外，两组阿托伐他汀治疗剂量均显示可以显著减少两种粘附分子的水平（P〈0．05），观察时段内各组对血脂水平影响无显著性差异（P〉0．05）结论阿托伐他汀治疗组比常规治疗组可以显著降低粘附分子水平，其中阿托伐他汀术后负荷剂量冲击治疗，较标准剂量更能显著降低血清粘附分子水平，从而抑制PCI术后的炎症反应的发生，减少术后再狭窄的发生。

Objective To explore the impact of different dose atorvastatin on the adhesion molecules level in the acute coronary syndrome （ACS） patients who had received percutaneous coronary intervention （PCI）. Methods Eighty-eight ACS patients were divided into three groups, group A （normal treatment group）, group B （normal treatment plus atorvastatin 10mg per day） and group C （normal treatment plus atorvastatin 80mg per day）. The patients in group B received atorvastatin 10 mg per day orally before PCI and after PCI subsequently, and the patients in group C received atorvastatin 80 mg per day orally before PCI and after PCI subsequently for three days, then the dose of atorvastatin was decrease to 10 mg per day. The concentrations of soluble intercellular adhesionmolecule-1 （sICAM- 1） and soluble vascular cell adhesion molecule-1 （sVCAM-1） were detected before PCI and at the 3rd, 7th 14th day after PCI. Results At the 7th day, the concentrations of sICAM-1 and sVCAM-1 in group C were significantly lower than those in group B, which showed sICAM-1 （68.35±23.80） μg/L vs （131.45±29.12）μg/L and sVCAM-1 （251. 65±36.61） μg/L vs （334.87±32.98）μg/L, respectively. Compared to group A, the adhesion molecule level in group B and group C were significantly decreased （P〈0.05） and had no obviously affect on blood fat level. Conclusion The treatment of atorvastatin could significantly decrease the adhesion molecules＇ level after PCI, which may play an important role in lowing inflammation and coronary artery restenosis after PCI.