瑞舒伐他汀对急性心肌梗死患者树突状细胞功能的影响

目的探讨瑞舒伐他汀对急性心肌梗死患者（AMI）树突状细胞（DC）功能的影响。方法将45例AMI患者分为常规治疗组（22例）和常规治疗加瑞舒伐他汀组（23例），分别于治疗前及治疗后2周抽血，分离外周血单个核细胞，制备DC。检测DC表型（CD86）、DC对同种异体T淋巴细胞的刺激能力、DC吞噬功能和凋亡细胞数、MLR上清液中的细胞因子，并与对照组比较。结果与对照组比较，AMI患者DC表面CD86的表达明显增高，对T淋巴细胞刺激能力增强，经DC刺激的淋巴细胞分泌致炎症细胞因子（IL-6，IL-12，肿瘤坏死因子a）增多，抑制炎症细胞因子（IL-10）减少，差异均有统计学意义（P〈0．01）。用瑞舒伐他汀前CD86的表达与血低密度脂蛋白胆固醇（LDL-C）水平正相关（r=0．63，P〈0．01）；瑞舒伐他汀抑制DC功能的同时显著降低血hs-CRP水平；且CD86与hs—CRP水平正相关（r=O．59，P〈0．01）。结论急性心肌梗死患者DC功能亢进，瑞舒伐他汀抑制斑块炎症的机制之一可能是抑制DC的功能。

Effects of Rosuvastatin on the Function of Dendritic Cells in Patients with Acute Myocardial Infarction.

Objective To investigate the function of dendritic cells （DC） in patients with acute myocardial infarction（AMI） and the effects of rosuvastatin on it. Methods 45 patients with AMI were divided into two groups, treatment group with 22 patients were treat- ed using conventional method and control group with 23 patients were treated using conventional and msuvastatin. Blood was drawn before the treatment and after two weeks of the treatment. Peripheral Blood Mononuclear Cells （PBMCs） were isolated from the blood, and they were incubated and induced to mature DC. Then we detected the expression of co-stimulating factor CD86 on DC, the stimu- lating capacity of DC and the level of cytokines in the medium of MLR, and they were compared between two groups. Results Com- pared with control group, CD86 on DC was much more expressed in AMI patients; the stimulating capacity of DC in MLR was higher; T lymphocytes in MLR secreted higher levels of pro-inflammatory cytokines （IL-6, IL-12and TNF-a） and lower level of anti-inflam- mation cytokine （IL-10）, differences were statistically significant（ P 〈 0.01）. Blood LDL-C before treatment was positively related to the expression of CD86. Rosuvastatin inhibited the function of DC and lowered blood level of hs-CRP and CD86, the levels of which were significantly positively correlated. Conclusions DC in AMI are activated, inhibitory effect of rosuvastatin on inflammation in AMI may be due to inhibition on DC.