替米沙坦对不稳定型心绞痛患者内皮祖细胞和高敏C反应蛋白的作用

Effects of telmisartan on high-sensitivity C-reactive protein and endothelial progenitor cells in patients with unstable angina pectoris

目的探讨替米沙坦对不稳定心绞痛患者内皮祖细胞(EPCs)和高敏C反应蛋白(hsCRP)的作用。方法选择经临床诊断患有不稳定型心绞痛并接受冠状动脉支架植入治疗患者70例为研究对象,随机分成A、B两组,每组35例。A组在应用常规药物治疗的基础上给以替米沙坦治疗,B组为对照组,在常规药物治疗基础上给予同等剂量安慰剂治疗,疗程均为4周。分别于经皮冠状动脉介入治疗(PCI)结束后即刻及应用药物4周后取外周静脉血,采用流式细胞仪检测法检测EPCs数量,采用免疫比浊法测定hsCRP水平。结果 PCI治疗4周后A组(应用替米沙坦组)的EPCs数量百分比较B组(安慰剂对照组)有明显升高(0.059±0.041)%vs(0.041±0.031)%(P<0.05),A组与4周前比较数量增多(0.059±0.041)%vs(0.027±0.021)%(P<0.01);血清hsCRP水平分析显示,A组较B组降低程度更为明显(2.9±1.7)mg/L vs(4.7±1.7)mg/L(P<0.01)。结论替米沙坦具有促进EPCs增殖、迁移、黏附等功能,同时具有降低血清hsCRP水平,抑制炎症反应等作用,可为临床中脉粥样硬化型疾病的预防、治疗及预后提供更有益的帮助。

Objective To investigate the effects of telmisartan on high-sensitivity C-reactive protein（hsCRP） and endothelial progenitor cells in patients with unstable angina pectoris（UAP）.Methods Seventy elderly patients with UAP were randomly divided into group A and group B with 35 patients in each group.All patients underwent coronary stenting treatment.After that,group A was treated with telmisartan and group B with placebo.Peripheral venous blood was taken immediately after percutaneous coronary intervention（PCI） treatment and four weeks after the application of drugs.Endothelial progenitor cells（EPCs） and the hsCRP level were detected.Results Four weeks after the application of drugs,EPCs of group A were significantly higher than those of group B,（0.059±0.041）% vs（0.041±0.031）%（P0.05）.After four weeks of treatment,EPCs increased significantly compared with before treatment（0.059±0.041）% vs（0.027±0.021）%（P0.01）.The hsCRP level of group A was significantly lower than that of group B（2.9±1.7） mg/L vs（4.7±1.7） mg/L（P0.01）.Conclusion Telmisartan can promote EPCs proliferation,migration,adhesion and other functions.It also can reduce serum hsCRP levels and inhibit the inflammatory response in patients with UAP.