阿托伐他汀调节急性冠状动脉综合征患者外周血辅助性T细胞亚群失衡的研究

目的观察急性冠状动脉综合征(acute coronary,syndromes,ACS)患者应用阿托伐他汀后外周血中1型辅助性T细胞(Th1)和2型辅助性T细胞(Th2)的频率及其相关细胞因子的变化,探讨他汀类药物对ACS患者辅助性T细胞分化的影响。方法选择ACS患者73例,随机分为安慰剂组(36例)和阿托伐他汀组(37例),入选实验后即刻,1、3、14天抽取外周血,检测Th1和Th2频率及其相关细胞因子的浓度,其中Th1相关细胞因子为干扰素γ、白细胞介素2,Th2相关细胞因子为白细胞介素4、白细胞介素10。结果安慰剂组与阿托伐他汀组即刻外周血Th1和Th2频率及其相关细胞因子水平比较,差异无统计学意义(P0.05);阿托伐他汀组外周血1、3、14天Th1相关细胞因子干扰素γ、白细胞介素2水平较安慰剂组明显降低(P0.05),而Th2相关细胞因子白细胞介素10水平较安慰剂组明显升高(P0.05);阿托伐他汀组1、3、14天Th1频率较安慰剂组明显降低(P0.05),而Th2频率两组间差异无统计学意义(P0.05)。结论阿托伐他汀通过调节Th1和Th2亚群分化失衡,抑制炎性反应,提示他汀类药物对ACS患者有更广泛的保护作用。

Atorvastatin modulates T helper 1 cells and T helper 2 cells imbalance in peripheral blood of patients with acute coronary syndrome

Objective To investigate immunomodulation by atorvastatin of T helper 1 and T helper 2(Thl/Th2) subsets imbalance in peripheral blood of patients with acute coronary syndrome (ACS).Methods Seventy-three patients with ACS were divided randomly into placebo group(36 cases) and atorvastatin group(37 cases).Th1/Th2 cells frequencies and concentration of related cytokines in peripheral blood were determined before initiation of treatment and on days 1,3 and 14.Results The frequencies of Thl/Th2 cells and concentration of related cytokines had no significant difference between two groups before initiation of treatment (P> 0.05).Th1 related cytokines IFN-γ and IL-2 were in lower levels in atorvastatin group than in placebo group on days1, 3 and 14 (P<0.05).Th2 related cytokine IL-10 was in higher level in atorvastatin group than in placebo group (P< 0.05).The frequency of Th1 cells decreased significantly in atorvastatin group compared with placebo group on days 1,3 and 14 (P< 0.05),while the frequency of Th2 cells had no statistically significant difference between the 2 groups (P> 0.05).Conclusions Atorvastatin significantly attenuated Th1 cells expansion and elevated the concentration of Th2 related cytokines.It can modulate Th1/Th2 development imbalance and inhibit inflammation to protect ACS patients from serious complication.