他汀序贯疗法对急性冠状动脉综合征合并2型糖尿病患者炎性因子和脂联素影响的研究

Effect of statin sequential therapy on adiponectin and inflammatory markers in acute coronary syndrome patients with type 2 DM

目的探讨他汀序贯疗法对急性冠状动脉综合征(ACS)合并2型糖尿病患者炎性因子和脂联素的影响。方法选择ACS患者119例,将合并糖尿病患者61例分为对照1组32例和序贯治疗1组29例,ACS未合并糖尿病患者58例分为对照2组28例和序贯治疗2组30例;另选糖尿病患者31例为糖尿病对照组,正常体检者26例为正常对照组。比较各组脂联素、可溶性血管细胞黏附因子1(sVCAM-1)、脂蛋白磷脂酶A2(Lp-PLA2)、妊娠相关蛋白A(PAPP-A)水平。结果与正常对照组比较,糖尿病对照组脂联素明显降低,sVCAM-1、Lp-PLA2、PAPP-A明显升高(P<0.01)。与对照1组和对照2组比较,序贯治疗1组和序贯治疗2组脂联素水平明显升高,sVCAM-1、Lp-PLA2、PAPP-A明显降低(P<0.01)。结论他汀序贯疗法可明显提高合并或未合并糖尿病ACS患者的脂联素水平,降低其炎症标记物水平。ACS合并或未合并糖尿病患者应用他汀序贯疗法后,对脂联素和血清炎症标记物的影响无明显差异。

Objective To study the effect of statin sequential therapy on adiponeetin and inflamma- tory markers in acute coronary syndrome （ACS） patients with DM. Methods Of the 119 ACS pa- tients included in this study,61 with DM were divided into control group 1 （n=32） and sequential therapy group 1 （n=29） ,58 without DM were divided into control group 2 （n=28） and sequential therapy group 2 （n=30）. Another 31 DM patients served as a DM control group and 26 subjects undergoing health check served as a normal control group. Their serum levels of adiponectin, solu- ble vascular adhesion molecular 1 （sVCAM-1）, lipoprotein-associated phospholipase A2 （Lp-PLA2）, pregnancy -associated plasma protein A （PAPP-A） were measured and compared. Results The serum adiponectin level was significantly lower while the serum sVCAM-1,Lp-PLA2 and PAPP-A levels were significantly higher in DM control group than in normal control group （P〈0.01）. The serum adiponectin level was significantly higher while the serum sVCAM-1 ,Lp-PLA2 and PAPP-A levels were significantly lower in sequential therapy groups 1 and 2 than in control groups 1 and 2 （P〈0.01）. Conclusion Statin sequential therapy can significantly increase the adiponectin level and decrease the inflammatory markers levels in ACS patients with or without DM. No signifi- cance difference is found in adiponectin and inflammatory markers levels in ACS patients with or without DM after statin sequential therapy.