急性心肌梗死患者血浆心肌营养素-1的变化及阿托伐他汀的干预作用

目的 探讨急性心肌梗死(AMI)患者血浆心肌营养素-1(CT-1)水平的变化及阿托伐他汀的干预作用.方法 56例AMI患者在入院后随机分为Ⅰ组(阿托伐他汀20 mg/d,n =28)与Ⅱ组(阿托伐他汀40mg/d,n =28),另选24名健康体检者为对照组.治疗前及治疗2周后分别检测患者血脂、血浆CT-1及高敏C反应蛋白( hs-CRP)水平,观察AMI后CT-1的变化及其与hs-CRP的相关性,同时观察阿托伐他汀的干预作用.结果 AMI患者血浆CT-1、hs-CRP浓度明显高于对照组(336.2±51.5 pg/mL vs 43.6±10.6 pg/mL,P＜0.01;29.12±9.83 ng/mL vs8.76±3.45 ng/mL,P ＜0.01)且血浆CT-1水平与hs-CRP成正相关(r=0.732,P＜0.01)；阿托伐他汀治疗后,两组血浆CT-1及hs-CRP水平均下降(P＜0.01),血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平均低于治疗前(P＜0.05或P＜0.01),Ⅱ组血浆CT-1、hs-CRP、TC、LDL-C水平下降较Ⅰ组更明显(P＜0.0]1)结论 AMI患者血浆CT-1、hs-CRP浓度明显升高,二者呈明显正相关,二者可能共同参与了AMI的发病过程,并与AMI的炎症反应密切相关.阿托伐他汀除具有调脂、抗炎作用外,CT-1可能是其非降脂作用的又一机制.

Changes of plasma cardiotrophin-1 in patients with acute myocardial infarction and the effects of atorvastatin

【Objective】 To explore the changes of plasma cardiotrophin-1(CT-1) in patients with acute myocardial infarction(AMI) and the effects of atorvastatin.【Methods】 56 patients with AMI were randomly allocated into groupⅠ(atorvastatin 20 mg/d,n =28),groupⅡ(atorvastatin 40 mg/d,n =28) and 24 healthy persons served as control group.The level of lipid,plasma concentrations of CT-1 and hypersensitive C reactive protein(hs-CRP) were measured before and two weeks after treatment.Changes of plasma CT-1,correlation between CT-1 and hs-CRP and the effects of atorvastatin were analyzed.【Results】 Plasma concentrations of CT-1 and hs-CRP in AMI patients were higher than those in control group(336.2±51.5 pg/mL vs 43.6±10.6 pg/Ml,P <0.01;29.12±9.83 ng/mL vs 8.76±3.45 ng/mL,P <0.01).The level of CT-1 was positively correlated with hs-CRP(r =0.732,P <0.01);Levels of CT-1,hs-CRP,TC,TG and LDL-C in both groupⅠand groupⅡwere significantly decreased after atorvastatin treatment(P <0.05,P <0.01).Levels of CT-1,hs-CRP,TC and LDL-C in groupⅡwere significantly lower than those in groupⅠ(P <0.01).【Conclusion】 Plasma concentrations of CT-1 and hs-CRP in AMI patients are higher than those in healthy persons.The level of CT-1 was positively correlated with hs-CRP.They may be involved in the inflammation and the process of AMI.Atorvastatin can decrease the level of CT-1 besides inhibiting inflammation and decreasing lipid.