瑞舒伐他汀对AMI病人血清脂联素和IL-18水平影响

EFFECTS OF ROSUVASTATIN ON SERUM ADIPONECTIN AND IL-18 IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

目的观察不同剂量瑞舒伐他汀对急性心肌梗死(AMI)病人血清中脂联素、白细胞介素18(IL-18)水平的影响。方法 66例AMI病人均于发病12h内行经皮冠状动脉介入术(PCI),术中见至少一根血管完全闭塞,所有病人均给予常规治疗(硝酸脂类药物、β受体阻滞剂、氯吡格雷、阿司匹林、低分子肝素),术后随机分成两组,分别给予瑞舒伐他10mg(10mg组)、瑞舒伐他汀20mg(20mg组),每日1次,用药前及用药后4周测量血清中脂联素、IL-18的水平。结果药物治疗4周后,10mg组、20mg组脂联素水平较治疗前明显升高,差异有显著意义(t=5.980、4.184,P<0.05),且10mg组与20mg组治疗前后差值比较,差异有显著性(t=2.459,P<0.05);4周后两组IL-18水平均较治疗前明显下降,,差异有显著性(t=2.239、5.466,P<0.05),且10mg组与20mg组治疗前后的差值比较,差异有显著性(t=2.594,P<0.05)。结论瑞舒伐他汀可提高AMI病人血清中抗炎因子脂联素的水平,降低致炎因子IL-18水平,有较好的抗炎效果,且高剂量的变化更明显,效果更显著,呈剂量依赖性。

Objective To observe the effects of different doses of Rosuvastatin on Adiponeetin （APN） and Interleukin-18 （1L-18） levels in patients with acute myocardial infarction （AMI）. Methods Sixty-six patients with AMI underwent PCI within 12 h of the attack, at least one vessel of each patient was seen completely blocked at the procedure. All the patients received conventional therapy-nitrates,β-reeeptor blockers, elopidogrel, aspirin,and low molecular heparin. The patients were randomized to two groups as rosuvastatin 10 mg/d group （10 mg/d group）, rosuvastatin 10 mg, once a day or rosuvastatin 20 mg/d group （20 mg/d group） rosuvastatin 20 mg, once a day. Serum APN and IL-18 were measured before and four weeks after medication. Results After four weeks of medication, the levels of APN in the two groups markedly elevated as compared with before therapy （t =5.980,4.184;P〈0.05）, and the differential value between the two groups was significantly diversed （t =2.459,P〈0.05）; the levels of IL-18 in the two groups significantly declined （t=2. 239,5. 466;P〈0.05）, and the differential value between the two groups was significantly different （t=2.594,P〈0.05）. Conclusion Rosuvastatin can raise the levels of anti-inflammatory factor-Adiponeetin, and lower the pro-inflammatory factor-IL-18, in serum of patients with acute myocardial infarction, which has a better anti-inflammatory efficacy in a dose-dependent manner, the higher the dose is, the more notable the effectiveness will he.