阿托伐他汀对急性冠状动脉综合征患者硫化氢和一氧化氮水平的影响

目的比较不同剂量的阿托伐他汀对于急性冠状动脉综合征(ACS)患者体内硫化氢和一氧化氮水平的影响。方法选取2010-2011大连医科大学附属第二医院心内科住院确诊的ACS患者81例为实验组,分为不稳定型心绞痛(UAP)、ST段抬高性心肌梗死(STEMI)及非ST段抬高性心肌梗死(NSTEMI)3个临床亚组。选取同期无明确高血压、冠状动脉性心脏病(冠心病)、糖尿病病史体检者21例为对照组。ACS患者中随机选取组成他汀治疗40mg组(35例)和他汀治疗20mg组(46例),治疗1周。用定量ELISA法测定血浆硫化氢,硝酸还原法检测血清一氧化氮水平。比较不同剂量阿托伐他汀对患者体内硫化氢、一氧化氮水平的影响。结果治疗1周后,20及40mg剂量组患者硫化氢、一氧化氮含量明显高于治疗前[20mg:硫化氢(31.26±3.18)比治疗前(27.93±5.55)μmol/L,一氧化氮(98.50±9.68)比治疗前(78.96±16.18)μmol/L,40mg:硫化氢(36.60±3.02)比治疗前(30.53±7.64)μmol/L,一氧化氮(127.46±14.55)比治疗前(80.69±19.92)μmol/L;均P<0.01];且40mg剂量组治疗后硫化氢、一氧化氮较治疗前的差值比20mg剂量组明显升高[硫化氢(6.37±4.82)比(3.31±2.44)μmol/L;一氧化氮(45.77±14.19)比(19.15±6.21)μmol/L;均P<0.01]。结论 ACS患者体内硫化氢、一氧化氮水平较低,应用阿托伐他汀治疗后可增加ACS患者体内硫化氢、一氧化氮含量。

The effect of atorvastatin on hydrogen sulfide and nitric oxide in patients with acute coronary syndrome

Objective To observe the effect of different doses of atorvastatin on hydrogen sulfide and nitric oxide in patients with acute coronary syndrom(ACS).Methods Eighty-one patients with ACS(including unstable angina pectoris,ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction) in the second hospital affiliated to Dalian medical university from 2010-2011 were selected.Twenty-one healthy patients were chosen as control group.The patients in the experimental group were randomly divided into atorvastatin 20 mg/d group(n=46),and atorvastatin 40 mg/d group(n=35).The level of hydrogen sulfide(H2S) in plasma was detected by ELISA and the serum nitric oxide(NO) level by nitrate reductase assay.Results The levels of H2S and NO in patients given atorvastatin(20 mg/d and 40 mg/d) were higher after treatment [20 mg,H2S(31.26±3.18) vs baseline(27.93±5.55)μmol/L,NO(98.50±9.68) vs baseline(78.96±16.18)μmol/L,40 mg,H2S(36.60±3.02) vs baseline(30.53±7.64)μmol/L,NO(127.46±14.55) vs baseline(80.69±19.92)μmol/L,P<0.01].Bigger changes of H2S and NO were observed after treatment with atorvastatin 40 mg/d compared with administration of atorvastatin 20 mg/d [H2S(6.37±4.82) vs(3.31±2.44)μmol/L,NO(45.77±14.19) vs(19.15±6.21)μmol/L,P<0.01].Conclusion The levels of H2S and NO were lower in the patients with ACS.Atorvastatin could increase the plasma H2S and NO levels in ACS patients.