阿托伐他汀对不同亚型冠心病患者血清IgG4及hs-CRP水平的影响

Effect of atorvastatin on serum IgG4 and hs-CRP levels in patients with different subtypes coronary heart disease

目的探讨阿托伐他汀治疗前后不同亚型冠心病(CHD)患者血清IgG4和超敏C反应蛋白(hs-CRP)水平变化情况及与CHD患者病情的相关性。方法选取2017年3月至2018年2月该院收治的193例CHD患者为研究对象,将所有患者分为3个亚型组:不稳定型心绞痛(UAP)组92例,稳定型心绞痛(SAP)组60例,急性心肌梗死(AMI)组41例。采用双抗体夹心酶联免疫吸附法检测各亚型组患者血清IgG4和hs-CRP水平,分析IgG4和hs-CRP水平与冠状动脉病变支数和Gensini积分之间的相关性。所有患者入院后予以阿托伐汀(40 mg/d)连续治疗1个月,观察治疗前后患者血清IgG4和hs-CRP水平变化。结果治疗前,IgG4、CRP水平及病变支数、Gensini积分:AMI组高或多于UAP、SAP组,UAP组高或多于SAP组,差异均有统计学意义(P<0.05)。Pearson分析显示,IgG4和hs-CRP水平与病变支数和Gensini积分均呈正相关[相关系数(r)=0.335、0.357,P<0.05;r=0.391、0.413,P<0.05)]。治疗后,UAP、AMI组IgG4水平较治疗前下降,差异均有统计学意义(P<0.05),SAP组无明显变化(P>0.05);AMI组IgG4水平高于UAP、SAP组,差异均有统计学意义(P<0.05),但UAP组和SAP组比较,差异无统计学意义(P>0.05)。治疗后,各亚型组hs-CRP水平较治疗前下降,差异均有统计学意义(P<0.05),但各亚型组hs-CRP水平组间比较,差异均无统计学意义(P>0.05)。结论CHD各亚型患者血清IgG4和hs-CRP水平存在明显差异,且与冠状动脉病变支数和Gensini积分呈正相关,而阿托伐他汀能有效降低IgG4和hs-CRP水平。

Objective To investigate the changes of serum IgG4 and high-sensitivity C-reactive protein(hs-CRP)levels in patients with different subtypes coronary heart disease(CHD)before and after atorvastatin treatment and their correlation with the disease conditions of patients with CHD.Methods A total of 193 patients with CHD treated in the hospital from March 2017 to February 2018 were selected as research objects.All of the patients were divided into 3 subtypes group:unstable angina pectoris group(UAP group,n=92),stable angina pectoris(SAP group,n=60),acute myocardial infarction group(AMI,n=41).The serum IgG4 and hs-CRP levels were detected by double antibody sandwich enzyme-linked immunosorbent assay in each subgroup.The correlation between IgG4,hs-CRP levels and the coronary artery lesions count and Gensini score were analyzed.All of the patients were treated with atorvastatin(40 mg/d)for 1 month,the changes of IgG4 and hs-CRP levels were observed before and after treatment.Results Before treatment,the IgG4,hs-CRP levels and coronary artery lesions count,Gensini score:AMI group were higher or more than those of UAP group and SAP group,UAP group were higher or more than those of SAP group,the differences were statistically significant(P<0.05).Pearson analysis showed those IgG4 and hs-CRP levels were positively correlated with the coronary artery lesions count and Gensini score[correlation coefficient(r)=0.335,0.357,P<0.05;r=0.391,0.413,P<0.05)].After treatment,IgG4 levels of UAP group and AMI group were decreased,the differences were statistically significant(P<0.05),the SAP group had no significant change(P>0.05);IgG4 level of AMI group were higher than that of UAP group and SAP group,the differences were statistically significant(P<0.05),but there was no significant difference in UAP group and SAP group(P>0.05).Compared with before treatment,the hs-CRP levels of three groups were decreased after treatment,the differences were statistically significant(P<0.05),but there were no significant differences among each subgroup(P>0.05).Conclusions The serum IgG4 and hs-CRP levels have significant differences in patients with different subtypes CHD,and positively correlated with the coronary artery lesions count and Gensini score.Atorvastatin can effectively reduce the levels of IgG4 and hs-CRP.