不同剂量阿托伐他汀短期治疗对急性冠脉综合症患者PCI围手术期血浆sCD163的影响

The effect of different doses of short-term atorvastatin on the concentration of plasma sCD163 in patients with acute coronary syndrome during perioperative period of PCI

目的 观察不同剂量阿托伐他汀对急性冠脉综合征患者PCI围手术期血浆sCD163浓度的影响,进一步探讨其炎症抑制机制和短期强化治疗的有效性.方法 将入选患者60例随机分为阿托伐他汀负荷剂量组（PCI术前2 d予阿托伐他汀80 mg/d,PCI术后予40 mg/d,30例）及阿托伐他汀常规剂量组（PCI术前术后均为20 mg/d,30例）,于PCI术前及术后18 ～24 h内取患者外周新鲜静脉血,测定并比较两组患者PCI围手术期血浆sCD163和血脂水平的浓度变化.结果 两组患者阿托伐他汀PCI术前术后血脂各指标的水平未见明显改变（P＞0.05）,两组患者PCI术后血浆sCD163浓度与术前相比均有所下降,但其中阿托伐他汀负荷剂量组的血浆sCD163浓度于PCI术后降低更明显（P＜0.05）,而阿托伐他汀常规剂量组血浆sCD163浓度下降不明显（P＞0.05）.结论 早期强化阿托伐他汀治疗可降低ACS患者围手术期血中sCD163水平,且呈剂量依赖性.

Objective To investigate the effect of different-dose of atorvastatin on plasma levels of hemoglobin scavenger receptor（ CD163 ） in patients with acute coronary syndrome（ACS） during perioperative period of pereutaneous coronary intervention （PCI）, to further discuss the inflammatory inhibition mechanism and the efficiency of short-term intensive statin treatment. Methods A total of 60 ACS patients were randomly divided into loading dose of statin group （ atorvastatin 80mg/d 2days before PCI, then 40mg/d after PCI, n = 30） and conventional dose of statin group （ atorvastatin 20mg/d before and after PCI, n = 30）. The plasma levels of sCD163 and lipids were measured before PCI and 18 -24 hours after PCI. Results No significant changes of lipid levels were observed in any group before and after treatment. After PCI, the levels of sCD163 in the two groups were decreased, but the loading dose of statin group decreased more obvious compared to before PCI （P 〈 0.05）, while the conventional dose of statin group show no significant difference between before and after PCI （P 〉 0.05 ）. Conclusions Early aggressive statin treatment in ACS patients can decrease the levels of sCD163 in a dose-dependent manner during perioperative period of PCI.