瑞舒伐他汀干预前后急性冠状动脉综合征患者血清白细胞介素17的变化及意义

Significance of serum IL-17 level in patients with acute coronary syndrome before and after rosuvastatin treatment

目的探讨瑞舒伐他汀干预前后急性冠状动脉综合征(ACS)患者血清白细胞介素17(IL-17)的变化及意义。方法选取我院心血管内科收治的ACS患者48例(A组),另选取同时期我院收治的稳定性心绞痛患者30例(B组)。检测2组患者的血脂、高敏C反应蛋白、心肌酶以及冠状动脉病变支数并分析其与血清IL-17的相关性;用瑞舒伐他汀对A组患者进行干预治疗,对比干预前后4周2组患者血清IL-17水平的变化情况。结果治疗前A组患者血清IL-17水平显著高于B组[(34.41±6.37)ng/L vs(15.18±3.11)ng/L,P<0.05];与治疗前比较,A组患者治疗4周后血清IL-17水平显著下降至(16.71±4.72)ng/L,差异有统计学意义(P<0.05),治疗后2组患者血清IL-17水平比较,差异无统计学意义(P>0.05)。多元回归分析显示,高敏C反应蛋白、肌钙蛋白、冠状动脉病变支数与血清IL-17水平呈正相关(P=0.012,0.008,0.000)。结论 ACS患者血清IL-17水平能够在一定程度上反映病情的严重程度,早期应用瑞舒伐他汀干预,可减轻机体炎性反应、降低血清IL-17水平,对稳定冠状动脉斑块、降低ACS的发病有重要意义。

Objective To study the significance of serum IL-17 level in patients with acute coronary syndrome（ACS）before and after rosuvastatin treatment.Methods Forty-eight ACS patients served as group A and 30 stable angina pectoris patients served as group B in this study.Their blood-lipid level and serum hs-CRP and myocardial enzyme levels were measured and the number of coronary artery branches with lesions was calculated.Their association with serum IL-17 level was analyzed.Patients in group A were treated with rosuvastatin.The serum IL-17 levels were compared in two groups before and 4weeks after rosuvastatin treatment.Results The serum IL-17 level was significantly higher in group A than in group B before rosuvastatin treatment（34.41±6.37ng/L vs 15.18±3.11ng/L,P〈0.05）and significantly lower in group A 4weeks after rosuvastatin treatment than before rosuvastatin treatment（16.71±4.72ng/L vs 34.41±6.37ng/L,P〈0.05）.No significant difference was found in serum IL-17 level between the two groups after rosuvastatin treatment（P〉0.05）.Multivariate regression analysis showed that the serum hs-CRP and troponin level and the number of coronary artery branches with lesions were positively related with the serum IL-17level（P=0.012,0.008,0.000）.Conclusion Serum IL-17 level in ACS patients can partly reflect the severity of ACS.Early treatment of ACS with rosuvastatin can reduce the inflammatory reactions and serum IL-17 level,and is of great significance in stabilizing the coronary plaques and reducing the incidence of ACS.