早期辛伐他汀强化治疗对急性冠状动脉综合征患者血小板氧化低密度脂蛋白内皮受体-1表达的影响

Impact of early intensified use of simvastatin treatment on platelet oxidized low-density lipoprotein receptor-1 expression in patients with acute coronary syndrome

目的:观察早期应用辛伐他汀强化治疗对急性冠状动脉综合征(ACS)患者血小板氧化低密度脂蛋白内皮受体-1(LOX-1)表达和近期预后的影响。方法:87例ACS患者随机分为A、B组,A组患者在常规药物治疗基础上早期给予辛伐他汀20mg/晚,B组患者在常规药物治疗基础上早期给予辛伐他汀60mg/晚,入院后次日及1周后采血检测肝肾功能、血糖、血脂、血小板聚集功能、血小板LOX-1的表达,观察入院后30d内主要心血管事件。结果:治疗后2组患者血小板LOX-1水平均有明显下降,B组下降更明显,2组比较差异有统计学意义(2.91±0.65∶2.61±0.51,P<0.05)。治疗后2组患者血小板聚集功能均有明显下降,B组降低更明显,2组比较差异有统计学意义(34.2±11.1∶29.4±7.7,P<0.05)。B组较A组30d内主要心血管事件发生更低。结论:早期强化他汀类药物治疗ACS患者短期内能抑制血小板功能,改善患者的近期预后,这可能与抑制血小板LOX-1的表达有关。

Objective：To observe the effect of early intensified use of simvastatin treatment on platelet oxidized low-density lipoprotein receptor-1（ LOX-1） expression and short-term prognosis,in patients with acute coronary syndrome. Method：Eighty-seven cases with ACS were randomly divided into A,B group,Patients in A group based on conventional drug therapy was given simvastatin 20 mg/night,patients in B group based on conventional drug therapy was given simvastatin 60 mg/night Blood liver and kidney function,blood sugar,blood lipids,platelet aggregation,platelet expression of LOX-1 was tested on the first day after admission and the day after a week,major cardiovascular events was observed within 30 days after admission.Result：After a week,both groups have decreased platelet aggregation,B group reduced more significantly than A group （34.2±11.1 vs 29.4±7.7,P〈0.05）. The platelet LOX-1 levels were significantly decreased in two groups after treatment too,B group decreased more significantly（2.91±0.65 vs 2.61±0.51,P〈0.05）. Major cardiovascular events within 30 days after admission occurred less in group B.Conclusion：The early intensive simvastatin therapy in patients with acute coronary syndrome can inhibit platelet function and improve short-term prognosis of patients,it may work by inhibiting platelet LOX-1 expression.