阿托伐他汀对冠心病患者血清细胞因子水平影响的研究

目的探讨阿托伐他汀对冠心病患者血清细胞因子水平的影响.方法用酶联免疫吸附法和常规酶法测定45例常规治疗组和45例阿托伐他汀治疗组冠心病患者治疗前后血清可溶性细胞间粘附分子-1(sICAM-1)、肿瘤坏死因子-α(TNF-α)水平以及总胆固醇(TC)水平的变化.结果与常规治疗组相比,阿托伐他汀组病人治疗4、8周后sICAM-1、TNF-α以及TC水平均明显降低(p均<0.05),并且上述三个因子水平治疗4、8周后均呈逐渐下降趋势(p均<0.05).阿托伐他汀组sICAM-1水平降低与TNF-α水平降低呈相关性(p<0.05),但sICAM-1和TNF-α水平降低与TC降低无相关性(p均>0.05).结论阿托伐他汀可以降低冠心病患者血清sICAM-1和TNF-α水平,减轻冠心病的炎症反应,并且这种机制独立于降脂作用以外.     

氟伐他丁对ACS患者CRP及sICAM-1、sVCAM-1的影响

目的:研究氟伐他丁对急性冠状动脉综合征(ACS)患者血清C-反应蛋白(CRP)及可溶性细胞黏附分子-1(sICAM-1)、可溶性血管细胞黏附分子-1(sVCAM-1)的影响.方法:采用随机、对照的方法将109例ACS患者分为氟伐他丁组(55例)和常规治疗组(54例),另选50例健康人为对照组,测定治疗前、治疗8周后血清CRP、sICAM-1、sVCAM-1的变化.结果:①ACS患者血清CRP、sICAM-1、sVCAM-1水平明显高于对照组(P＜0.01).②氟伐他丁组治疗8周后血清CRP、sICAM-1、sVCAM-1水平显著降低(P＜0.01).而常规治疗组治疗后无显著变化.结论:氟伐他丁对ACS患者有抗炎抗细胞黏附作用.     

三种血管内皮损伤指标血清水平与冠心病病变范围的关系

目的:探讨血清可溶性血管细胞黏附分子-1(sVCAM-1)、可溶性细胞间黏附分子-1(sICAM-1)、血管性血友病因子(vWF)水平与冠心病(CHD)病变范围的相关性。方法:根据冠脉造影结果将87例患者分为CHD组(63例)和对照组(24例)。采用ELISA平行检测两组血清sVCAM-1、sICAM-1和vWF水平,酶法测定血脂水平,比较两组患者sVCAM-1、sICAM-1、vWF及血脂水平的差异,并进行相关性分析;以冠脉狭窄支数作为判断CHD病变范围的依据,探讨不同病变范围患者血清sVCAM-1、sICAM-1和vWF的水平变化。结果:CHD组血清sVCAM-1、sI-CAM-1、vWF水平显著高于对照组(P<0.01);血清sVCAM-1、sICAM-1和vWF水平与血脂水平之间无明显相关性(P>0.05);单支冠脉狭窄组血清sVCAM-1、sICAM-1水平显著低于多支冠脉狭窄组(P<0.05)。结论:CHD患者血清sV-CAM-1、sICAM-1和vWF水平升高,sVCAM-1、sICAM-1水平与CHD病变范围有关。     

经皮冠状动脉介入术前他汀再负荷对围术期循环内皮祖细胞及炎症因子的影响

 目的:探讨经皮冠状动脉介入术（PCI）术前大剂量阿托伐他汀再负荷治疗对长期他汀治疗的稳定性冠心病病人围术期循环内皮祖细胞（EPCs）及炎症因子的影响。方法:将长期他汀治疗并择期PCI的稳定性心绞痛患者随机分为3组：术前12 h 80 mg阿托伐他汀负荷及术前2 h追加40 mg阿托伐他汀再负荷治疗（80 mg再负荷组）、连续7 d 40 mg阿托伐他汀再负荷治疗（40 mg再负荷组）和无阿托伐他汀再负荷治疗（无再负荷组）。应用流式细胞术分别测定所有患者PCI术前1 h、术后1 h、6 h及24 h外周血中标记为CD45-/CD133+/CD34+、CD45-/CD34+/KDR+ 和CD45-/CD144+/KDR+的EPCs数量;术前即刻及术后24 h分别测定血清可溶性细胞间黏附分子1（sICAM-1）、C反应蛋白（CRP）和肌钙蛋白（TnI）水平。结果:（1）80 mg再负荷组患者PCI术前与术后1 h外周血标记为CD45-/CD133+/CD34+和 CD45-/CD34+/KDR+的EPCs数量均有显著差异（P<0.05）,PCI术前与术后6 h外周血标记为上述两种指标的EPCs差异显著（P<0.05）;外周血标记为CD45-/CD144+/KDR+的EPCs在PCI术前和术后无显著变化;无再负荷组及40 mg再负荷组患者外周血EPCs在PCI术前和术后无显著变化。（2）PCI术后24 h无再负荷组sICAM-1及CRP水平较术前显著升高（P<0.05）。PCI术后24 h 80 mg再负荷组和40 mg再负荷组sICAM-1和CRP的升高幅度有减少趋势。（3）与无再负荷组相比,80 mg再负荷组PCI术后24 h 血清TnI升高幅度显著降低（P<0.05）。结论: PCI术前阿托伐他汀再负荷方式影响围术期外周血EPCs数量。术前大剂量他汀短时间再负荷治疗提高围术期外周血中早期EPCs的数量。PCI术前阿托伐他汀再负荷治疗减少围术期炎症反应及心肌损伤。     

强化阿托伐他汀对老年冠状动脉介入后血清MCP-1、hs-CRP和sFas因子的影响

目的:探讨阿托伐他汀对老年冠状动脉介入治疗术(PCI)后血清单核细胞趋化蛋白1(MCP-1)、高敏C反应蛋白(hs-CRP)和血浆可溶性Fas(sFas)的影响。方法:52例接受PCI的稳定型心绞痛患者随机分为观察组和对照组,对照组予常规治疗;观察组在对照组基础上予口服阿托伐他汀40 mg,qd,治疗4~7 d后行PCI术。于术前及术后24 h、1周测定患者血清MCP-1、hs-CRP和血浆sFas水平。MCP-1、sFas检测采用酶联免疫吸附法,hs-CRP采用免疫比浊法。结果:两组hs-CRP、MCP-1及sFas水平术后24 h升高,术后1周低于术后24 h,观察组较对照组下降更明显,两组差异有统计学意义(P0.05)。结论:老年冠状动脉介入治疗术后应用大剂量阿托伐他汀能促进MCP-1、hs-CRP和sFas水平下降,有利于动脉粥样硬化斑块的稳定,预防再狭窄的发生。     

阿托伐他汀治疗前后脑梗死患者颈动脉斑块的变化

目的:观察阿托伐他汀对脑梗死患者颈动脉斑块的作用。方法:68例脑梗死患者除常规治疗外,加用口服阿托伐他汀胶囊20mg,每晚1次,测定开始治疗及连续服用阿托伐他汀胶囊5个月后颈动脉内膜中层厚度(IMT)和血清C反应蛋白(CRP)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平变化。结果:阿托伐他汀胶囊治疗5个月后,患者颈动脉IMT缩小,与治疗前比较,差异有统计学意义(P<0.05)。TC、TG、LDL-C和CRP显著低于治疗前水平(P<0.05)。结论:阿托伐他汀胶囊除有降脂作用外,还可以稳定并缩小脑梗死患者颈动脉斑块。     

SREBP1 在阿托伐他汀抑制NLRP1 炎性体表达中的作用

目的:探讨固醇调节元件结合蛋白1(SREBP1)在阿托伐他汀抑制核苷酸结合寡聚化结构域样受体蛋白1(NLRP1)炎性体表达中的作用。方法:160 nmol/ L 佛波酯孵育THP- 1 细胞12 h,使其分化为巨噬细胞,更换无血清培养基,加入脂多糖和(或)阿托伐他汀进行处理。Real-time PCR 检测细胞中NLRP1、SREBP1 mRNA 的表达;Western blot 检测细胞中NLRP1、SREBP1 蛋白的表达;检测SREBP1 siRNA 预处理细胞后对阿托伐他汀抑制NLRP1 表达的影响。结果:阿托伐他汀能抑制THP-1 巨噬细胞NLRP1 和SREBP1 的mRNA 和蛋白的表达;单独使用SREBP1 siRNA 处理细胞可有效抑制NLRP1 的表达,且与单独使用阿托伐他汀无明显差异;同时使用SREBP1 siRNA 和阿托伐他汀处理细胞比单独使用一种对NLRP1 的抑制作用更为显著。结论:阿托伐他汀可能通过SREBP1 途径抑制NLRP1 的表达,进而发挥抗炎效应。     

阿托伐他汀对冠心病患者血清细胞因子水平影响的研究

目的 探讨阿托伐他汀对冠心病患者血清细胞因子水平的影响。方法 用酶联免疫吸附法和常规酶法测定45例常规治疗组和45例阿托伐他汀治疗组冠心病患者治疗前后血清可溶性细胞间粘附分子-1（sICAM—1）、肿瘤坏死因子-a（TNF—a）水平以及总胆固醇（TC）水平的变化。结果 与常规治疗组相比，阿托伐他汀组病人治疗4、8周后sICAM—1、TNF—α以及TC水平均明显降低（p均〈0．05），并且上述三个因子水平治疗4、8周后均呈逐渐下降趋势（p均〈0，05），阿托伐他汀组sICAM—1水平降低与TNF—α水平降低呈相关性（p〈0，05），但sICAM—1和TNF—α水平降低与TC降低无相关性（P均〉0．05）。结论 阿托伐他汀可以降低冠心病患者血清sICAM—1和TNF—α水平，减轻冠心病的炎症反应，并且这种机制独立于降脂作用以外。     

阿托伐他汀治疗介入术后冠心病患者的临床疗效与安全性

目的：研究阿托伐他汀治疗介入术后冠心病患者的治疗效果及影响。方法选取120例我院2010年7月~2013年7月收治的冠心病患者,所有患者均行介入术治疗,治疗后将所有患者随机分为两组各60例。对照组患者使用常规治疗,在治疗的同时每日口服阿托伐他汀20mg,观察组患者同样使用常规治疗,在治疗的同时每日口服阿托伐他汀80mg。结果治疗后发现,两组患者均比原先有所改善,P>0.05;且观察组患者在血脂(除HDL-C外)、C反应蛋白、心肌缺血情况上均好于对照组,P>0.05;不良反应发生率两组无差异,P>0.05。结论阿托伐他汀在治疗介入术后冠心病患者的效果显著,可有效的降低血脂及C反应蛋白,防止心肌缺血的发生。且治疗效果随着剂量的增加而增加,值得临床应用及推广。     

阿托伐他汀对老年2型糖尿病血脂异常患者颈动脉斑块的影响

目的:观察阿托伐他汀对老年2型糖尿病血脂异常患者颈动脉斑块的影响。方法:选择80例2型糖尿病血脂异常患者,随机分为阿托伐他汀治疗组(治疗组,40例)和非阿托伐他汀治疗组(对照组,40例),治疗组每晚顿服阿托伐他汀片10mg,对照组每晚服用一片安慰剂,两组的疗程均为24周。测定两组治疗前和治疗12、24周时患者血脂和血清超敏C-反应蛋白(hs-CRP)水平,并通过彩超观察两组治疗前后颈动脉斑块大小及颈动脉内膜-中层厚度(CI-MT)的变化。结果:治疗12周,治疗组患者胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和hs-CRP均较治疗前明显降低(P<0.05),且颈动脉斑块大小和CI MT较治疗前明显减小(P<0.05),治疗24周时效果更显著(P<0.01)。结论:阿托伐他汀对老年2型糖尿病血脂异常患者具有降脂和抗炎作用,并降低CI MT,减少颈动脉斑块,改善动脉粥样硬化进程。     

Vascular inflammation in cerebral small vessel disease

Cerebral small vessel disease (CSVD) is considered to be caused by an increased permeability of the blood-brain barrier and results in enlargement of Virchow Robin spaces (VRs), white matter lesions, brain microbleeds, and lacunar infarcts. The increased permeability of the blood-brain barrier may relate to endothelial cell activation and activated monocytes/macrophages. Therefore, we hypothesized that plasma markers of endothelial activation (adhesion molecules) and monocyte/macrophage activation (neopterin) relate to CSVD manifestations. In 163 first-ever lacunar stroke patients and 183 essential hypertensive patients, we assessed CSVD manifestations on brain magnetic resonance imaging (MRI) and levels of C-reactive protein (CRP), neopterin, as well as circulating soluble adhesion molecules (sICAM-1, sVCAM-1, sE-selectin, sP-selectin). Neopterin, sICAM-1 and sVCAM-1 levels were higher in patients with extensive CSVD manifestations than in those without (p < 0.01). Neopterin levels independently related to higher numbers of enlarged Virchow Robin spaces (p < 0.001). An inflammatory process with activated monocytes/macrophages may play a role in the increased permeability of the blood brain barrier in patients with CSVD.     

急性冠脉综合征病人血清中E-选择素、可溶性细胞间粘附分子-1和可溶性血管细胞间粘附分子-1含量的变化

目的:探讨急性冠脉综合征病人血中粘附分子表达在识别不稳定冠脉粥样硬化斑块中的作用。方法:选取急性冠脉综合征病人80例, 其中急性心肌梗死病人40例, 不稳定心绞痛病人40例, 急性冠脉综合征病人经治疗4个月后进行随访, 同时选取正常对照40例。采用酶联免疫法(ELISA)测定血清中E-选择素、可溶性细胞间粘附分子-1(sICAM-1)和可溶性血管细胞间粘附分子-1(sVCAM-1)的水平。结果:外周血中E-选择素、sICAM-1、sVCAM-1水平在急性心肌梗死组、不稳定心绞痛组显著高于对照组, 除sVCAM-1外在随访时明显降低。结论:外周血中E-选择素、sICAM-1的水平可能作为诊断和预测急性冠脉综合征发生的敏感指标, 并可以反映冠脉粥样硬化斑块的稳定情况。     

冠心病患者血浆OLAB、BNP和CRP水平变化分析

检测冠心病患者血浆OLAB、BNP和CRP水平变化, 探讨冠心病发病机制及不稳定性心绞痛(UAP)治疗前后对其影响.用RIA和ELISA法对124例冠心病患者和30名对照者血浆中的OLAB、BNP和CRP水平变化及相关性进行研究, 同时对48例UAP经皮冠状动脉形成术(PTCA)治疗前、后对上述三项指标的变化进行分析; 结果表明冠心病患者与对照组比较BNP水平有显著性差异(P＜0.01),尤其是AMI和UAP组比SAP组升高更明显; CRP水平比对照组明显增高(P＜0.05),特别是不稳定性心绞痛和AMI组升高明显(P＜0.05);AMI组血浆OLAB水平明显高于正常和其他两组, OLAB、BNP和CRP三项在UAP组中治疗前后比较差异显著(P＜0.01).总之,OLAB、BNP和CRP参与了冠心病的发病过程, 并可预测心肌梗死患者远期心功能恢复的情况, UAP组经PTCA支架术后, 三项指标均明显降低, 可作为疗效观察的一个重要参数, OLAB参与了冠状动脉粥样硬化的全过程及AMI的发病始末.     

曲美他嗪联合阿托伐他汀钙治疗冠心病心绞痛伴血脂异常的临床研究

目的 研究曲美他嗪联合阿托伐他汀钙治疗冠心病心绞痛伴血脂异常的临床疗效。方法 选择2017年3月~2018年5月在我院治疗的124例冠心病心绞痛伴血脂异常患者,将其随机分为对照组和观察组,各62例。对照组口服阿托伐他汀钙,观察组在此基础加用曲美他嗪,观察两组临床疗效、心绞痛发作情况及不良反应,比较两组患者TC、TG、LDL-C、HDL-C变化水平。结果 观察组治疗总有效率高于对照组（88.70% vs 67.74%）,差异有统计学意义（P＜0.05）;治疗后观察组TC、TG、LDL-C水平低于对照组,HDL-C水平高于对照组,差异均有统计学意义（P＜0.05）;观察组心绞痛发作次数（2.10±1.12）次/周、持续时间（2.27±1.18）min,低于对照组的发作次数（2.82±1.30）次/周、持续时间（2.84±1.32）min,差异有统计学意义（P＜0.05）;观察组不良反应发生率与对照组对比（3.22% vs 4.83%）,差异无统计学意义（P＞0.05）。结论 曲美他嗪联合阿托伐他汀钙治疗冠心病心绞痛伴血脂异常疗效显著,可减少心绞痛发作次数,缩短发作时间,有效改善患者血脂水平,且临床用药安全。     

Does infection with Chlamydia pneumoniae and/or Helicobacter pylori increase the expression of endothelial cell adhesion molecules in humans?

Objective   To investigate if Chlamydia pneumoniae and/or Helicobacter pylori seropositivity is associated with elevated levels of soluble endothelial cell adhesion molecules (sCAMs) as markers of atherosclerotic activity.
Methods   Immunoglobulin A (IgA) and IgG antibodies to the two bacteria, soluble intercellular cell adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1) and E-selectin were measured in coronary heart disease (CHD) patients ( n  = 193) and age- and sex-matched controls ( n  = 193). Two different serological methods were used for the detection of Chlamydia antibodies: Labsystems microimmunofluorescence to detect species-specific C. pneumoniae antibodies and Medac's recombinant enzyme-linked immunosorbent assay to detect genus-specific lipopolysaccharide antibodies.
Results   The concentrations of sICAM-1 and E-selectin were higher in CHD patients with positive vs. negative Chlamydia lipopolysaccharide IgA ( P  = 0.044 for both). H. pylori antibodies alone did not predict raised levels of sCAMs, but in CHD patients sICAM-1 was increased with IgA seropositivity to both bacteria compared to double seronegativity ( P  = 0.034). Concentrations of sVCAM-1 were elevated in CHD patients with double IgA seropositivity compared to those with Chlamydia lipopolysaccharide IgA seropositivity alone ( P  = 0.018).
Conclusion   Our results may indicate that C. pneumoniae contributes to increased inflammation in CHD, and that this contribution is even more pronounced when present in combination with H. pylori IgA antibodies.     

Evaluation of the association of serum levels of hyaluronic acid,sICAM-1, sVCAM-1, and VEGF-A with mortality and prognosis in patients with Crimean-Congo hemorrhagic fever

BackgroundCrimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral hemorrhagic disease. Pathogenesis of the disease has not been well described yet. A well-known pathogenic feature of CCHF virus is its capability to damage endothelium. Increased hyaluronic acid (HA) levels indicate liver sinusoidal endothelial damage. Soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1) and vascular endothelial growth factor-A (VEGF-A) play a role in the inflammatory process, vascular damage and plasma leakage.ObjectivesTo investigate whether or not there is a relationship between HA, sICAM-1, sVCAM-1 and VEGF-A serum levels and fatality in CCHF.Study designSixty-one patients who were confirmed by RT-PCR and serological tests for CCHF, included in the current study. HA, sICAM-1, sVCAM-1, VEGF-A levels in serum samples were analyzed by ELISA.ResultsThere were statistically significant differences between fatal and non-fatal CCHF patients in terms of HA, sICAM-1, sVCAM-1, and VEGF-A levels. In addition, AST and ALT levels were positively correlated with HA, sICAM-1, sVCAM-1, and VEGF-A levels.ConclusionHA, sICAM-1, sVCAM-1, and VEGF-A levels of the patients that died during hospitalization were statistically significantly higher than the patients that survived, and this finding suggests that the level of these molecules could be used as a prognostic marker in CCHF.     

Differential up-regulation of circulating soluble selectins and endothelial adhesion molecules in Sicilian patients with Boutonneuse fever.

In 150 patients with Boutonneuse fever (BF), caused by Rickettsia conorii, we studied the plasma levels of soluble L-selectin (sL-selectin), vascular cell adhesion molecule-1 (sVCAM-1), intercellular adhesion molecule-1 (sICAM-1) and E-selectin (sE-selectin) in various phases of disease to clarify their role in disease evolution. Results indicate that during the acute phase of BF there is a significant increase in the serum levels of sL-selectin, sE-selectin, sVCAM-1 and sICAM-1. sL-selectin and sVCAM-1 returned to normal levels in the third week of disease, whereas sE-selectin and sICAM-1 persisted at significantly high levels even after the third week. The secretion of these soluble CAMs in BF is mainly the result of leucocyte expression and endothelial cell activation, but secretion also appears to mediate anti-inflammatory activities, moderating leucocyte adhesion and reducing in particular lymphocyte and monocyte infiltration. Only sL-selectin serum levels were found to correlate with the acute phase of infection characterized by fever.     

Indices of low-grade chronic inflammation in polycystic ovary syndrome and the beneficial effect of metformin

BACKGROUND: Women with polycystic ovary syndrome (PCOS) have an increased prevalence of insulin resistance (IR) and related disorders. Elevated serum levels of cellular adhesion molecules (CAMs) reflect low-grade chronic inflammation and have been associated with several insulin-resistant states. The objective of this study is to investigate whether soluble inflammatory markers [soluble intercellular adhesion molecule-1 (sICAM-1), soluble endothelial leukocyte adhesion molecule-1 (sE-selectin), soluble vascular cell adhesion molecule-1 (sVCAM-1) and C-reactive protein (CRP)] are altered in PCOS and to further elucidate the effect of metformin treatment on their levels. METHODS: Two young populations were studied [62 women with PCOS and 45 normal women of similar age, BMI and waist-to-hip ratio (WHR)]. Plasma levels of sICAM-1, sVCAM-1, sE-selectin and high-sensitivity CRP (hsCRP) were measured in both groups. Additionally, the effect of metformin on these molecules was investigated in 22 women with PCOS who accepted to metformin protocol (1700 mg daily for a 6-month period). RESULTS: In the total population studied, plasma levels of hsCRP (mg/l), sICAM-1 (ng/ml) and sE-selectin (ng/ml) were higher in the PCOS group compared with those in controls (hsCRP 1.31 +/- 0.22 versus 0.92 +/- 0.27, P = 0.014, sICAM-1 301.21 +/- 24.80 versus 209.86 +/- 17.05, P = 0.025, sE-selectin 57.37 +/- 4.08 versus 45.67 +/- 4.62, P = 0.045, respectively). sVCAM-1 (ng/ml) did not differ statistically among the two groups (P = 0.896). A significant reduction in hsCRP and sVCAM-1 was achieved after 6 months of metformin administration: PCOS pretreatment hsCRP 1.92 +/- 0.60 versus PCOS post-treatment hsCRP 0.52 +/- 0.26, P = 0.005; PCOS pretreatment sVCAM-1 668.09 +/- 98.38 versus PCOS post-treatment sVCAM-1 365.82 +/- 99.77, P = 0.039. CONCLUSION: These findings imply the presence of chronic inflammation in women with PCOS. Metformin decreases the levels of plasma inflammatory indices. Further investigation is required to determine whether these findings may prove to be of clinical significance for PCOS patients.