丹参多酚酸盐对冠脉内支架置入术后细胞因子水平的影响

Effect of Salvianolate on Cytokins Level in Patients with Unstable Angina Pectoris after Stent Implantation.

目的研究丹参多酚酸盐对不稳定型心绞痛(UAP)患者冠脉内支架置入后血清细胞因子水平的影响。方法将68例UAP患者随机分为常规治疗组及丹参多酚酸盐治疗组(丹参多酚酸盐组),观察支架置入前、支架置入后24h及1周血清白细胞介素18(IL-18),白细胞介素1(IL-1)以及可溶性细胞间黏附分子-1(sICAM-1)水平的变化,并与18例正常对照组比较。结果治疗前UAP患者血清IL-18、IL-1以及sICAM-1水平较正常对照组明显升高(均P<0.01),常规治疗组支架置入后24h较治疗前升高(P<0.05),治疗后1周较治疗前降低(P<0.05)。丹参多酚酸盐组支架置入后24h上述3种细胞因子水平较治疗前降低(P<0.05),治疗后1周降低更明显(P<0.01)。且丹参多酚酸盐组较常规治疗组下降明显(P<0.05)。结论 IL-18、IL-1和sICAM-1不同程度参与不稳定型心绞痛以及支架置入后冠状动脉管壁损伤的病理生理过程。丹参多酚酸盐可能通过调节上述细胞因子的表达,减轻冠脉局部的炎症级联反应,对UAP患者及支架置入后发挥较全面心血管保护作用。

Objective To investigate the serum level of cytokins and the effect of salvianolate in the patients with unstable angina pectoris （UAP） after stent implantation. Methods 68 patients undergoing stent implantation were divided randomly into conventional therapy group and salvianolate group. The level of Interleukin - 18（ IL - 18 ）, interleukin - 1 （ IL - 1 ） and intercellular adhesion molecular （ ICAM - 1 ） were evaluated by ELISA method before and 24h and 1 weeks after stent implantation. The level of IL - 18 ,L - 1 and ICAM - 1 were evaluated by ELISA, and the level of these cytokins were compared with 18 normal controls. Results The levels of serum IL - 18 ,IL - 1 and sICAM - 1 in patients with UAP were higher than those in the control group （P 〈0.01 ） and they were decreased 24 h after stent implantation in salvianolate group （ P 〈 0.05 ）, while there was significant increase in conventional therapy group （ P 〈 0.05 ）. The levels of the three cytokins were decreased both in conventional therapy group （P 〈0.05）and in salvianolate group （P 〈 0.01 ） lw after stent implantation, with more novel effect in the latter group （ P 〈 0.01 ）. Conclusion It suggests that IL - 18, IL - 1 and sICAM - 1 may take part in the development of unstable angina pectoris and artery injury after stent implantation. Salvianolate may inhibit the inflammation in coronary artery by decreasing the secretion of IL- 18, IL- 1 and sICAM -1 ,thus play a protective role in patients with UAP after stent implantation.