冠心病妇女绝经后雌激素替代治疗对趋化因子受体 CXCR2的影响

Effect of estrogen replacement therapy on chemokine receptor CXCR2 in monocytes in postmenopausal women with coronary artery disease

目的 :探讨经雌激素替代治疗后的绝经后冠心病妇女外周血单核细胞趋化因子受体 CXCR2的变化。方法 :选 2 2例已绝经的冠心病妇女为观察组 ,2 0例绝经后健康妇女作为对照组。两组受试者又随机分为干预组和安慰剂组 ,干预组口服结合型雌二醇 (倍美力 ) ,每日 0 .6 2 5 mg,连续 3个月。安慰剂组口服安慰剂 (维生素 C)。观察对象均分别于用药前及用药 3个月末抽血测血清雌二醇 ( E2 )水平、外周血单核细胞趋化因子受体 CXCR2蛋白表达水平。 结果 :( 1)治疗前冠心病组血清 E2 、CXCR2蛋白水平显著低于正常对照组 ( P<0 .0 1) ;( 2 )经过雌激素干预治疗 3个月后 ,绝经后妇女血清 E2 水平均显著上升( P<0 .0 1) ,外周血单核细胞趋化因子受体 CXCR2水平均显著下降 ( P<0 .0 1) ,且冠心病组较对照组变化更明显 ;( 3)血清 E2水平与 CXCR2水平变化呈显著负相关 ( r=-0 .46 )。 结论 :雌激素替代治疗后的绝经后妇女外周血单核细胞趋化因子受体CXCR2下调 ,且有冠心病者变化更明显 。

Objective: To study the change of chemokine receptor CXCR2 in monocytes in postmenopausal women with coronary artery disease (CAD) after estrogen replacement therapy. Methods: Randomized placebo controlled trial was conducted in 22 post menopausal women with CAD and 20 normal menopausal women by giving 0.625 mg premarin daily or vitamin C treatment for 3 months. Serum estradiol (E 2) and chemokine receptor CXCR2 in peripheral blood monocytes were measured at 0 and 3 months of treatment. Results:(1) E 2 and CXCR2 levels in the CAD group was lower than that in the normal group ( P <0.01). (2) After premarin treatment, E 2 level was significantly increased( P <0.01), but chemokine receptor CXCR2 level was significantly decreased ( P <0.01) both in the CAD group and the normal groups, and the change in the CAD group was much larger than that in the normal group ( P <0.05); (3) There was a significant negative correlation between E 2 level and chemokine receptor CXCR2 level ( r =-0.46). Conclusion:The cardioprotective effect of estrogen replacement therapy may be due to estrogen induced chemokine receptor CXCR2 decrease in monocytes.