瑞舒伐他汀对急性冠状动脉综合征合并心律失常患者炎性因子变化的影响

Effect of rosuvastatin on inflammation factor in patients with acute coronary syndrome combined with arrhythmia

目的观察瑞舒伐他汀对急性冠状动脉综合征(ACS)合并心律失常患者炎症和凋亡反应的作用。方法选择ACS患者171例,按是否合并心律失常分为心律失常组(83例)和对照组(88例),予瑞舒伐他汀10mg每日睡前顿服,治疗2周。治疗前后分别检测人高敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF)-α和白细胞介素(IL)-1β基因以及Bcl-2和C-myc蛋白表达水平。结果两组间性别构成、年龄、疾病构成、合并疾病、治疗情况及治疗前后一般生化指标的差异均无统计学意义(P值均>0.05)。治疗前,对照组的hs-CRP、TNF-α和IL-1βmRNA表达及C-myc蛋白表达水平均显著低于心律失常组(P值均<0.05),Bcl-2蛋白表达水平均显著高于心律失常组(P值均<0.05)。治疗2周后,两组的hs-CRP、TNF-α和IL-1β mRNA表达及C-myc蛋白表达水平均显著降低(P值均<0.05),Bcl-2蛋白表达水平均显著升高(P值均<0.05),两组间上述指标的差异均无统计学意义(P值均>0.05)。结论 ACS合并心律失常患者的炎症和凋亡反应明显,可能是心律失常发生和持续的原因。瑞舒伐他汀具有抗炎、抗凋亡作用,可能与其治疗心律失常的作用相关。

Objective To investigate the protective effects of rosuvastatin against the inflammation damage and apoptosis factors in patients with acute coronary syndrome （ACS） combined with arrhythmia. Methods Totally 171 ACS patients were divided into with arrhythmia group （n = 83, ACS with arrhythmia） and control group （n = 88, ACS without arrhythmia）. They orally took rosuvastatin （10 mg/d） at bedtime for 2 weeks. High-sensitivity C-reactive protein （hs-CRP）, tumor necrosis factor a （TNF-α）, interleukin 113 （IL-1β）, Bcl-2 and C-myc were measured before and after treatment. Results There were no statistical differences in the general data （gender, age, constituent ratio of illness, comorbidities, treatment and common examination indexes） between two groups before and after treatment （all P〉0.05）. Before taking rosuvastatin, hs-ORP, TNF-α, IL-1β and C-myc in the control group were significantly lower than those in the arrhythmia group, while Bcl-2 in the control group was significantly higher than that in the arrhythmia group （all P〈0.05）. hs-CRP, TNF-α, IL-1β, and C-myc were significantly decreased and Bcl-2 was significantly increased in both groups 2 weeks after rosuvastatin therapy （all P〈0. 05）, but there were no statistical differences between the two groups （all P〉0. 05）. Conclusion There are significant inflammation and apoptosis reactions in ACS patients combined with arrhythmia, which may be related to the development and sustaining of arrhythmia. Rosuvastatin has protective effects against inflammation and apoptosis on myocardium, which may contribute to the treatment of arrhythmia.