辛伐他汀对不稳定性心绞痛患者巨噬细胞集落刺激因子及血脂水平的影响

Effect of simvastatin on macrophage colony stimulating factor and blood lipids in unstable angina

目的 观察辛伐他汀对不稳定性心绞痛患者血清巨噬细胞集落刺激因子 (M CSF)水平的影响 ,以期探讨 3 羟 3 甲基戊二酰辅酶A还原酶抑制剂调脂以外的抗炎作用机制。方法 根据入院顺序 ,将 5 0例不稳定性心绞痛患者随机分为基本治疗组 (对照组 )与辛伐他汀 +基本治疗组 (用药组 ) ,分别于治疗前及治疗 8周后检测血脂及血清M CSF、肿瘤坏死因子 α(TNF α)及C反应蛋白 (CRP)水平。结果 用药组 8周后血清甘油三酯、低密度脂蛋白胆固醇、总胆固醇较治疗前水平下降 ,高密度脂蛋白水平轻度上升 ,而对照组无变化 ;对照组、用药组血清M CSF、TNF α、CRP水平均有降低 ,但降低的幅度用药组M CSF、TNF α明显大于对照组 ,而CRP两组间无差异。用药组治疗前后除TNF α的变化值与高密度脂蛋白变化值呈负相关外 ,M CSF、TNF α、CRP的变化与血脂各项的变化均无相关性。结论 辛伐他汀在调脂的同时 ,还通过抑制不稳定性心绞痛患者血清炎性细胞因子水平 。

Objective To observe the effect of simvastatin on the serum levels of macrophage colony stimulating factor in unstable angina in order to investigate the non lipid mechanisms of 3 hydroxy 3 methylglutarcoenzymeA reductase inhibitors(statins) on inflammation.Method According to the order of admission to the hospital, 50 selected patients were randomly allocated to two groups: control group(basic treatment,n=20) and treatment group( basic treatment plus simvastatin,n=30).All patients were treated for eight weeks. Before and at the end of treatment period,serum macrophage colony stimulating factor (M CSF)、tumor necrosis factor alpha(TNF α)、C reactive protein(CRP)and blood lipids were measured. Results After the treatment,the serum levels of TC、TG 、LDL in treatment group declined notably and serum HDL increased,while no change was observed in control group.The reduction of serum levels of M CSF,TNF α and CRP were observed in both groups,but the degree of reduction of M CSF and TNF α was greater in treatment group than in control group and the degree of reduction of CRP had no difference.There was no correlation between the changes of M CSF, TNF α,CRP and serum lipids,but negative correlation between TNF α and HDL was observed before and after treatment in treatment group.Conclusion The study suggests that besides modulating lipids, simvastatin possesses its anti inflammatory activity via the inhibition of proinflammatory cytokines.