血浆趋化因子受体CCR1在急性冠脉综合征患者围术期强化他汀治疗中的作用

目的观察负荷量阿托伐他汀对急性冠脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术后的影响及血浆CC趋化因子受体1(CCR1)在其中的作用。方法 120例ACS患者随机均分为试验组和对照组,试验组入院后30min内给予阿托伐他汀80mg,PCI术当日起40mg/d,30d后改为20mg/d;对照组入院后起即给予阿托伐他汀20mg/d。观察两组围术期心肌梗死及30d主要不良心血管事件(MACE)的发生率;ELISA法检测术前、术后24h、1、2、4周血浆CCR1水平。结果试验组围手术期心肌梗死发生率明显低于对照组(5.00%vs.23.33%)(P<0.01);30dMACE发生率低(3.33%vs.15.00%)(P<0.05)。与PCI术前比较,对照组术后24h血浆CCR1明显升高(P<0.01);两组术后1、2、4周两组CCR1的水平均明显下降(P<0.01),试验组低于对照组(P<0.01)。结论术前强化阿托伐他汀治疗显著降低ACS患者PCI术后CCR1水平,从而减少围手术期心肌梗死和30dMACE发生率。

Role of CCR1 in loading-dose atorvastatin in patients with acute coronary syndrome undergoing percutaneous coronary intervention

Objective To investigate the role of CC chemokine receptor 1(CCR1) in the treatment of loading-dose atorvastatin in the patients with acute coronary syndrome(ACS) undergoing percutaneous coronary intervention(PCI).Methods A total of 120 ACS patients was equally randomized into groups of A and B.Group A received atorvastatin 80 mg before 30 minutes of PCI,40 mg/d after PCI,and then 20 mg/d after 30 days.Group B received atorvastatin 20 mg/d before and after PCI.PCI associated myocardial infarction(MI) and major adverse cardiac events(MACE) in 30 days after PCI were recorded.The plasma concentration of CCR1 was detected by ELISA method before PCI,at 24 hours,1 week,2 weeks and 4 weeks after PCI,respectively.Results The incidence rates of PCI-associated MI and MACE in 30 days after PCI were significantly lower in group A than those in group B(5.00% vs.23.33% and 3.33% vs.15.00%)(P<0.01 and P<0.05).Compared with before,plasma concentration of CCR1 in group B increased at 24 hours after PCI(P<0.01),which thereafter was decreased in both groups and was lower in group A than that in group B(P<0.01).Conclusion Loading-dose atorvastatin used before 30 minutes of PCI could significantly decrease the incidence of PCI-associated MI and MACE in 30 days after PCI by reducing serum CCR1.