阿托伐他汀对冠心病患者外周血单核细胞/巨噬细胞清道夫受体的影响

目的：观察冠心病患者外周血单核细胞（PBMs）转化巨噬细胞清道夫受体活性及血清炎性因子(包括CRP、sICAM-1 、sVCAM-1)的变化及阿托伐他汀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他汀类药物稳定粥样硬化斑块的可能机制。 方法： 75例血脂正常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3组，29例健康人作为对照。测定所有观察对象血清C反应蛋白、可溶性细胞间黏附分子（sICAM-1）、血管细胞黏附分子（sVCAM-1）水平；并在体外分离培养PBMs并转化为巨噬细胞, 观察阿托伐他汀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C反应蛋白、sICAM-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。阿托伐他汀能下调冠心病患者PBMs源性巨噬细胞清道夫受体活性。冠心病患者PBMs源性巨噬细胞清道夫受体活性与C反应蛋白、sICAM-1、sVCAM-1呈正相关。 结论： 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；阿托伐他汀可抑制冠心病患者血PBMs源性巨噬细胞清道夫受体活性。

Influence of atorvastatin on scavenger receptor of monocytes/macrophages in patients with coronary heart disease

AIM: To observe activity of scavenger receptor of macrophage derived from monocytes, the change of inflammation factor in plasma (including CRP, sICAM-1, sVCAM-1) and the influence of atorvastatin on activity of scavenger receptor in patients with coronary heart disease. METHODS: 75 patients with coronary heart disease (CHD), whose plasma lipid levels were normal, were divided into three groups: stable angina pectoris, unstable angina pectoris and acute myocardia infarction. 29 healthy persons were served as control. The level of C-reactive protein (CRP), soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in plasma were determined in all subjects. Monocytes in peripheral blood were dissevered and cultured to transform into macrophage. The influence of atorvastatin on activity of scavenger receptor in macrophage was observed. RESULTS: The level of CRP, sICAM-1, sVCAM-1 and activity of scavenger receptor of macrophage in acute myocardia infarction group were higher than that in stable angina pectoris, unstable angina pectoris and control. Atorvastatin lowered the activity of scavenger receptor of macrophages derived from monocytes in patients with coronary heart disease. Activity of scavenger receptor of macrophages derived from monocytes in patients with coronary heart disease was correlated positively with CRP, sICAM-1 and sVCAM-1. CONCLUSION: Activity of scavenger receptor may be taken as index for monitoring the degree of active vulnerable atherosclerosis plaque. Atorvastatin may inhibit activity of scavenger receptor in macrophages derived from monocytes in patients with coronary heart disease.