NSTE-ACS患者血清sLOX-1水平与冠状动脉病变严重程度的相关性及阿托伐他汀的干预作用

Correlation between sLOX-1 and severity of coronary lesions in patients with NSTE-ACS and the intervention effect of atorvastatin

目的:探讨非ST段抬高型急性冠状动脉综合征(NSTE-ACS)患者血清凝集素样氧化低密度脂蛋白受体-1(sLOX-1)水平与冠状动脉(冠脉)病变严重程度的相关性,以及阿托伐他汀的干预作用。方法:纳入NSTE-ACS患者136例(NSTE-ACS组)及对照组30例,采用Gensini评分系统评估冠脉病变严重程度,酶联免疫吸附法(ELISA)测定血清sLOX-1水平。给予NSTE-ACS组患者阿托伐他汀干预治疗6个月后再测血清sLOX-1水平。结果:与对照组相比,NSTE-ACS组血清sLOX-1水平明显升高(P<0.01);多项二元Logistic回归分析显示,血清sLOX-1水平是发生NSTE-ACS的独立预测因子(r=1.015,95%CI:1.006～1.025,P<0.01);Spearman相关分析显示,NSTE-ACS患者血清sLOX-1水平与Gensini呈独立正相关(r=0.223,P<0.05);6个月后阿托伐他汀治疗组血清sLOX-1水平较6个月前明显降低[(161.00±39.16)pg/ml∶(184.96±40.88)pg/ml,P<0.01]。结论:血清sLOX-1水平是预测NSTE-ACS发生及病变严重程度的生物标记物。阿托伐他汀可有效降低NSTE-ACS患者血清sLOX-1水平。针对LOX-1及其配体的干预有望成为稳定NSTE-ACS患者粥样硬化斑块的一种新机制。

Objective：To investigate the relationship between soluble lectin like oxidized low-density lipoprotein receptor 1 （sLOX -1） levels and the severity of coronary lesions in patients with non ST-segment elevation acute coronary syndrome （NSTE-ACS） and the intervention effect of atorvastatin. Method： All 136 patients with NSTE-ACS （NSTE-ACS group） and 30 healthy controls （control group） were enrolled. The severity of coronary artery disease was assessed by Gensini score system, sLOX-1 levels were measured by Enzyme-linked immunosor- bent assay （ELISA）. Serum sLOX-1 levels were measured in NSTE-ACS patients after treatment with atorvasta- tin for 6 months. Result： sLOX-1 level was significantly higher in NSTE-ACS group than that in control group （P〈0.01）. Polytomous Logistic regression analysis demonstrated that serum sLOX1 level was the independent predictor of NSTE-ACS （r=1.015, 95%CI： 1. 006~1. 025, P%0.01）. Spearman correlation analysis showed that there was a positive correlation between sLOX-1 and Gensini Score （r=0. 223, P〈0.05）. Serum sLOX-1 level was significantly reduced after the treatment of atrovatin for 6 months [（161.00±39.16）pg/ml ： （184.96± 40.88） pg/ml, P〈0. 011. Conclusion： Serum sLOX-1 level is a useful biomarker to predict NSTE ACS occurrence and severity of lesion. Atorvastatin could effectively reduce serum sLOX-1 levels in patients with NSTE-ACS. Interference aiming directly at LOX-1 and its ligands might be a potential mechanism to stabilize atherosclerotic plaque of NSTE ACS patients.