不同剂量阿托伐他汀对急性冠脉综合征患者血浆可溶性OX40配体水平的影响

目的探讨不同剂量阿托伐他汀对急性冠脉综合征(ACS)炎症指标可溶性OX40配体(sOX40L)及高敏C反应蛋白(hs-CRP)的影响。方法收集47例因ACS住院的患者,随机分为小剂量组(阿托伐他汀10 mg/d)25例和大剂量组(阿托伐他汀20 mg/d)22例,治疗4周,测定治疗前后血浆sOX40L及hs-CRP的浓度。结果小剂量组和大剂量组的sOX40L及hs-CRP的血浆基线水平分别为:(27.69±10.52)ng/L和(28.24±10.01)ng/L,(11.69±7.09)mg/L和(11.91±6.36)mg/L,均显著高于以往报道的正常人群。治疗4周后,小剂量组和大剂量组sOX40L均显著下降,分别为(21.99±8.12)ng/L(t=10.732,P0.01)和(17.51±4.84)ng/L(t=9.052,P0.01),下降幅度分别为20.6%和38.0%,差异有统计学意义(t=2.252,P0.05)。两组hs-CRP也显著下降,下降幅度分别为32.3%(t=5.496,P0.01)和55.8%(t=8.006,P0.01),两组间比较差异有统计学意义(t=2.702,P=0.01)。治疗前后sOX40L与hs-CRP均呈正相关性(R=0.765,P=0.00;R=0.742,P=0.00)。结论 ACS患者血浆sOX40L水平明显高于正常人群。他汀类药物治疗ACS患者可显著降低sOX40L,并且sOX40L降低与hs-CRP降低同步,呈剂量依赖性。sOX40L可能同hs-CRP一样,可作为他汀类药物抗炎作用的指标之一。

Effect of different dose of atorvastatin on plasma soluble OX40L level in patients with acute coronary syndrome

Objective To investigate the effect of different dose of atorvastatin on soluble OX40 ligand （sOX40L） and high-sensitivity C-reactive protein （hs-CRP） levels in patients with acute coronary syndrome （ACS）. Methods Forty-seven patients with ACS were randomly assigned into low dose group （atorvastatin 10 mg per day, n = 25 ） and high dose group （ atorvastatin 20 mg per day, n = 22 ）, and were followed up for 4 weeks. Plasma sOX40L and hs-CRP levels were analyzed at admission and 4 weeks after therapy. Results The baseline levels of sOX40L and hs-CRP in low dose group and high dose group were （27. 69 ± 10. 52） ng/L and （28.24 ± 10. 01 ） ng/L, （ 11.69±7.09） mg/L and （ 11.91 ±6. 36） mg/L respectively. After 4 weeks of treatment, sOXd0L levels were significantly decreased in both low dose group （21.99±8.12） ng/L, t =10.732, P〈0.01] and high dose group （17.51 ±4.84） ng/L, t =9.052, P〈0.01], with a reduction of 20. 6% and 38.0% respectively （t = 2. 252, P 〈 0. 05 ）. Significant drop were also observed in hs-CRP levels in both low dose group （ 32. 3%, P 〈 0. 01 ） and high dose group （ 55.8%, P 〈 0. 05 ）. Markedly positive correlations were found between sOX40L levels and hs-CRP levels before （R = 0. 765, P = 0. 00） and after therapy （R = 0. 742, P = 0. 00）. Conclusions Plasma sOX40L and hs-CRP levels were significantly increased in patients with ACS compared with healthy people. Atorvastatin significantly decreases sOX40L and hs-CRP levels in dose dependent fashion. Like hs-CRP, sOX40L may be another index for the evaluation of statin effect.