瑞舒伐他汀对高血压伴颈动脉硬化的疗效及对外周巨噬细胞极化的影响

Effects of rosuvastatin on hypertension with carotid atherosclerosis and its influence on peripheral macrophage polarization

目的:观察瑞舒伐他汀对高血压伴颈动脉硬化的临床效果及其对外周巨噬细胞极化的影响。方法:选择100例高血压伴颈动脉硬化患者,随机分为对照组和观察组,各50例。对照组予苯磺酸左旋氨氯地平2.5 mg qd,观察组在对照组治疗基础上,给予瑞舒服他汀10 mg qd晚餐顿服,疗程均为6个月。采用生化仪测定甘油三酯(triglycerides,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)及高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C);放射免疫法测定超敏C反应蛋白(hypersensitivity C-reaction protein,hs CRP);多普勒超声测定颈动脉内膜中层厚度(carotid intima-media thickness,CIMT);流式细胞仪测定巨噬细胞极化的变化。结果:经治疗后,观察组的TC、TG、LDL-C、hs CRP、CIMT水平均显著低于对照组,但HDL-C水平显著高于对照组,差异均有统计学意义(P<0.05)。观察组外周巨噬细胞表面表达的M1型比例明显低于对照组,而M2型比例明显高于对照组,均有统计学差异(P<0.05)。结论:瑞舒伐他汀可改善高血压伴颈动脉硬化的患者的血脂紊乱、炎症反应及CIMT,其作用机制可能与调节巨噬细胞的极化有关。

AIM ： To observe the effect of rosuv- astatin on carotid atherosclerosis in patients with hy- pertension and its effect on macrophage polarization. METHODS： 100 hypertensive patients with carotid atherosclerosis were randomly divided into Control group and Observation group, each of 50 cases. Control group was given amlodipine besylate 2.5 mg QD. On the basis of Control group, Observation group was given rosuvastatin 10 mg QD. The course of treatment was 6 months. The changes of total cho- lesterol （TC）, triglyceride （TG）, low density lipo- protein cholesterol （LDL-C） and high density lipo- protein cholesterol （HDL-C） were detected by bio- chemical analyzer, high sensitivity C reactive protein （hsCRP） by radioimmunoassay, multiple carotid in- tima-media thickness （CIMT） by Doppler ultra- sound, macrophage polarization by flow cytometry. RESULTS ：After treatment, the levels of TC, TG, LDL-C, hsCRP and CIMT in Observation group were significantly lower than those in Control group, while the level of HDL-C was significantly higher than that of Control group, the difference was statistically sig- nificant （P 〈0.05）. The expression of M1 markers （ CD64, CD11 c and CD40） on the surface of macro- phages in Observation group, was significantly lower than that in Control group, while the M2 markers （ CD206, CD14 and CD23 ） were significantly high- er than those in Control group, and the difference was statistically significant （ P 〈 0.05 ）. CONCLU- SION： Rosuvastatin can improve dyslipidemia, in- flammation and CIMT in patients with hypertension with carotid atherosclerosis, its mechanism may be related to the regulation of macrophage polarization.