急性冠状动脉综合征患者IGF轴的改变

目的研究急性冠状动脉综合征(ACS)患者IGF轴的改变及阿托伐他汀干预的影响。方法将70例ACS作为实验组;健康成年人68例作为对照组。治疗前各组在性别、年龄、心功能分级均无显著差异。ACS患者均予以阿托伐他汀(立普妥)20 mg/d治疗2周。分别于药物治疗前、治疗后2周采空腹静脉血,测定CK-MB、cTnI、PAPP-A、IGF-1、IGF-BP4、hs-CRP等指标;同时分离静脉血单核细胞,测定其IGF-1R基因mRNA表达量。结果 ACS患者组较健康成人对照组CK-MB、cTnI、hs-CRP、PAPP-A、IGF-1、IGF-BP4等指标均有显著差异(P<0.05),其中cTnI与hs-CRP差异极显著(P<0.01)。他汀治疗2周后,ACS患者血浆cTnI、CK-MB和hs-CRP浓度较治疗前明显降低(P<0.05),但与正常对照组相比仍有显著差异(P<0.05);治疗后PAPP-A与IGF-1均下降到正常对照组水平,但IGFBP-4水平较治疗前进一步上升(P<0.05);ACS患者治疗前、后单核细胞IGF-1R基因mRNA表达量均显著高于对照组(P<0.05)。结论 ACS患者血清IGF-1与IGFBP-4上升,阿托伐他汀可降低cTnI、CK-MB、hs-CRP、PAPP-A和IGF-1,增加IGFBP-4水平,但对IGF-1R表达无明显影响。

Changes of IGF axis in patients with acute coronary syndrome

Objective To study the changes of IGF axis in patients with acute coronary syndrome(ACS) and the effect of atorvastatin treatment.Methods 70 cases of ACS patients treated with atorvastatin were experimental group and 68 cases of healthy adults were composed as the control group.Before the treatment,all the groups have no significant difference in gender,age,and cardiac function classification.ACS patients were treated with atorvastatin(lipitor) 20 mg/d for 2 weeks.Venous blood was collected before and after the treatment to determine CK-MB,cTnI,hs-CRP,PAPP-A,IGF-1,IGF-BP4 index;mononuclear cells were isolated at the same time to examine their IGF-1R mRNA expressions.Results The CK-MB,cTnI,hs-CRP,PAPP-A,IGF-1,IGF-BP4 index of ACS patients were significantly differ from the healthy adults control group(P<0.05) while the cTnI and hs-CRP revealed very significant difference(P<0.01).After 2 weeks of treatment,the concentration of cTnI,CK-MB and hs-CRP in ACS group was obviously lower(P<0.05),but still abnormal when compared with the control group;after atorvastatin therapy,the serum PAPP-A and IGF-1 were significantly declined into the normal level compared with the control group while the IGFBP-4 concentration further increased significantly(P<0.05);the ACS patients’ IGF-1R,mRNA expression of mononuclear cells in both before and after the treatment were significantly higher than the control group.Conclusions Serum IGF-1 and IGFBP-4 level in ACS patients were increased and atorvastatin treatment could reduce cTnI,CK-MB,hs-CRP,PAPP-A and IGF-1,increase IGFBP-4 level,but have no significant effect on IGF-1R expression.