冠心病患者外周血单核细胞源性巨噬细胞清道夫受体活性变化及银杏叶提取物的干预作用

目的观察冠心病患者外周血单核细胞(peripheral blood monocyte，PBMs)转化为巨噬细胞清道夫受体活性及血清炎性因子的变化及银杏叶提取物(Gingko biloba extract，(jBE)对清道夫受体活性的影响，探讨炎性因子水平与清道夫受体活性关系及GBE稳定粥样硬化斑块的可能机制、方法97例血脂正常的冠心病患者分为稳定性心绞痛组、不稳定性心绞痛组、急性心肌梗死组，29名健康人作为对照组、测定所有观察对象血清C反应蛋白(CRP)、可溶性细胞间黏附分子-1(soluble intercellular adhesion molecule-1 sICAM-1)、可溶性血管细胞黏附分子-1(soluble vascular cell adhesion molecule-1，sVCAM-1)水平；并在体外分离培养PBMs转化为巨噬细胞，观察GBE对其表达清道夫受体的影响．结果巨噬细胞清道夫受体活性及血清CRP、slCAM-1、sVCAM-1水平，急性心肌梗死组＞不稳定性心绞痛组＞稳定性心绞痛组＞对照组、GBE能下调冠心病患者PBMs源性巨噬细胞清道夫受体活性．结论冠心病患者PBMs源性巨噬细胞清道夫受体活性与CRP、sICAM-1、sVCAM-1呈正相关，PBMs源性巨噬细胞清道夫受体活性可作为易损斑块活动程度的监测指标；GBE可抑制冠心病患者血PBMs源性巨噬细胞清道夫受体活性。

Change of Peripheral Blood Monocytes Derived Macrophage Scavenger Recep tors Activi ty in Patients with Coronary Heart Disease, and the Intervention Effect of Gink go Biloba Extract

OBJECTIVE: To observe the activity of peripheral blood monocytes (PBMs) derived macrophage scavenger receptors (MSR) and changes of serum inflammatory factor in peripheral blood in patients with coronary heart disease (CHD), and to evaluate the effect of Ginkgo biloba extract (GBE) on the MSR activity, to explore the relationship between inflammatory factor and scavenger receptors activity as well as the possible mechanism of GBE in stabilizing the atheromatous plaque. METHODS: Ninety-seven CHD patients with normal blood lipids were classified into the stable angina group, the unstable angina group and the acute myocardial infarction group, and 29 healthy persons were taken as control. Levels of C-reactive protein (CRP), soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in all subjects were determined. And their PBMs were isolated, cultured in vitro, and transferred into macrophage to observe the effect of GBE on the expression of scavenger receptors. RESULTS: The levels of MSR activity, CRP, sICAM-1 and sVCAM-1 in patients with acute myocardial infarction > unstable angina > stable angina > control. CONCLUSION: GBE could down-regulate the MSR activity in CHD patients, which was positively correlated with levels of CRP, sICAM-1 and sVCAM-1. MSR activity could be taken as a monitoring criteria for active degree of vulnerable atherosclerosis plaque. GBE has the effect of suppressing MSR activity.