氟伐他汀对心力衰竭患者血清可溶性细胞黏附分子的影响

Effects of fluvastatin on serum soluble cell adhesion molecule in patients with heart failure

目的:观察氟伐他汀短期治疗对充血性心力衰竭(congestive heart failure,CHF)患者血清中可溶性细胞间黏附分子-1(sICAM-1)、可溶性血管细胞黏附分子-1(sVCAM-1)、可溶性选择素E(sE-selectin)、可溶性选择素P(sP-selectin)和可溶性选择素L(sL-selectin)水平的影响,探讨氟伐他汀对CHF的治疗作用。方法:将70例CHF患者随机分为常规治疗组和干预组(氟伐他汀组)。正常对照组20例。采用酶联免疫吸附法(ELISA)测定其治疗前后血清中sICAM-1、sVCAM-1、sE-selectin、sP-selectin和sL-selectin水平。结果:血清可溶性细胞黏附分子(soluble cell adhesion molecules,sCAM)水平在心功能Ⅳ级明显高于心功能Ⅱ、Ⅲ级患者,而心功能Ⅱ、Ⅲ级之间比较差异无统计学意义,心功能Ⅱ-Ⅳ级的患者sCAM水平均高于正常对照组(P<0.05或P<0.01)。常规治疗组和干预组治疗后血清sCAM水平均较治疗前有显著下降(P<0.05或P<0.01),但干预组较常规治疗组仅sVCAM-1和sE-selectin下降水平显著(P<0.05),余各血清sCAM水平组间比较差异无统计学意义(P>0.05)。结论:CHF患者血清sCAM水平下降主要与心功能改善相关,在CHF常规治疗的基础上短期加用氟伐他汀治疗能降低sVCAM-1和sE-selectin水平。

Objective：To observe the effects of short-term treatment of fluvastatin on serum soluble intercellu lar adhesion molecule-1 （sICAM-1）, soluble vascular cell adhesion molecule -1 （sVCAM-1）, soluble E-selectin （sE selectin）, soluble P-selectin （sP-selectin） and soluble L-selectin （sL-selectin） in patients with congestive heart failure（CHF）, and investigate the effects of fluvastatin on the treatment of congestive heart failure. Methods： 70 CHF patients were randomly divided into conventional treatment group and intervention group （fluvastatin group）, normal control group has 20 cases, using enzyme-linked immunosorbent assay （ELISA） measure levels of serum sICAM-1, sVCAM-1, sE - Selectin, sP-selectin and sL-selectin before and after treatment. Results：Serum soluble cell adhesion molecules（sCAM） levels in patients with heart function class Ⅳ was significantly higher than patients with heart function class Ⅱ and Ⅲ , and the comparison between heart function class Ⅱ and Ⅲ was not significant, soluble cell adhesion molecules（sCAM） levels of patients with the heart function class Ⅱ-Ⅳ have an average increase than normal control Group （P〈0.05 or P〈0.01）. Serum sCAM levels of two groups have significant decrease after treatment （P〈0.05 or P〈0.01）, compare intervention group with the conventional treatment group, only sVCAM-1 and sE selectin levels decreased significantly （P〈0.05）, while the other inter-group comparison of serum sCAM levels has no statistical significant （P〉0.05）. Conclusion：The serum sCAM levels of CHF patients were related to the classification of cardiac function, on the basis of conventional treatment together with short-term fluvastatin treatment can not further reduce the total serum sCAM level, so consider effects of taking statin drugs to inflammatory factors may be related to the use of dose, time and the use of population, longterm effect depend on long-term and large samples to be studied further.