强化他汀治疗对ACS患者血清IL-37的影响

目的不同剂量阿托伐他汀对急性冠脉综合征(ACS)患者治疗后血清白介素-37(IL-37)水平的变化,探讨强化他汀治疗对IL-37与冠状动脉粥样硬化斑块的影响。方法将拟行冠脉介入治疗的110例ACS患者随机分为三组,其中常规治疗组30例(阿托伐他汀钙20 mg/晚);强化治疗A组40例(阿托伐他汀40 mg/晚,4周后改为20 mg/晚)、强化治疗B组40例(阿托伐他汀负荷量80 mg顿服1次,随后40 mg/晚,4周后改为20 mg/晚)。ELISA法测定其治疗前后外周静脉血清IL-37水平。结果 1ACS患者血清IL-37在治疗4周过程中呈逐步上升趋势(P0.05);2治疗4周时血清IL-37常规治疗组与强化治疗A组、强化治疗B相比差别有统计学意义(P0.05);3左室功能和校正TIMI计帧数(CTFC)常规治疗组与强化治疗A组、强化治疗B组相比差别有统计学意义(P0.05);4治疗4周时强化治疗A组与强化治疗B组在IL-37水平和临床结果上两组无统计学差别;5三组间的主要心脏不良事件和药物不良反应在4周时无统计学差别。结论 IL-37可作为监测和评估ACS患者的指标;强化他汀治疗可提高抗炎因子IL-37的水平,改善患者CTFC及左室功能;不良反应无增加。

Influence of intensive statin therapy on level of serum interleukin-37 in patients with acute coronary syndrome

Objective To observe the changes of serum interleukin-37 （IL-37） level in patients with acute coronary syndrome （ACS） treated with atorvastatin in different doses, and discuss the influences of intensive statin therapy on IL-37 level and coronary atherosclerotic plaques. Methods ACS patients （n=110） with planed PCI were randomly divided into 3 groups, including routine therapy group treated with atorvastatin （20 mg/night）, intensive group A treated with atorvastatin （40 mg/night and 20 mg/night after 4 w） and intensive group B treated with atorvastatin （80 mg once, then 40 mg/night and 20 mg/night after 4 w）. The level of serum IL-37 was detected by using ELISA before and after treatment. Results ①The level of serum IL-37 showed a gradual increasing tendency during 4-w treatment （P〈0.05）. ②The difference in level of serum IL-37 had statistical significant in routine therapy group compared with other 2 groups after treatment for 4 w （P〈0.05）. ③The difference in left ventricular function and calibration TIMI frame count （CTFC） had statistical significant in routine therapy group compared with other 2 groups （P〈0.05）. ④The level of serum IL-37 and clinical outcomes had no statistical difference between intensive group A and intensive group B after treatment for 4 w. ⑤The incidence of major adverse cardiovascular events （MACE） and adverse drug reactions had no statistical difference among 3 groups after 4 w. Conclusion The level of serum IL-37 can be taken as an index for monitoring and reviewing ACS patients. Intensive statin therapy can promote the level of serum IL-37 （anti-inflammatory cytokine）, and improve CTFC and left ventricular function without the increase of adverse drug reactions.