阿托伐他汀对慢性充血性心力衰竭患者外周血Toll样受体表达的影响

目的探讨慢性充血性心力衰竭(CCHF)患者外周血单个核细胞Toll样受体4(TLR4)表达改变情况及阿托伐他汀对其的干预效应。方法选取80例CCHF住院患者,其中40例按照标准治疗方案进行治疗(标准治疗组);另外40例在标准治疗的基础上口服阿托伐他汀20mg/d(阿托伐他汀组)。40名健康者为对照组。在治疗前和治疗后1个月,应用流式细胞仪检测外周血单个核细胞表面TLR4的表达,采用酶联免疫吸附试验检测血清肿瘤坏死因子(TNF)-α水平;并对TLR4的表达与血清TNF-α水平进行相关性分析。结果标准治疗组、阿托伐他汀组的外周血单个核细胞表面TLR4表达水平均较对照组显著升高(P值均<0.05),并且与血清TNF-α水平呈正相关(r=0.076,P<0.05)。治疗后1个月,标准治疗组和阿托伐他汀组的外周血单个核细胞表面TLR4的表达和血清TNF-α水平均较本组治疗前显著降低(P值分别<0.05、0.01),阿托伐他汀组的下降值均显著高于标准治疗组(P值均<0.05)。结论 TLR4表达可能与CCHF发生有关,阿托伐他汀可显著降低外周血单个核细胞表面TLR4的表达,提示阿托伐他汀的抗炎性免疫作用与抑制TLR4介导的炎性免疫反应有关。

Effect of atorvastatin on toll-like receptor 4 expression in peripheral blood of patients with chronic congestive heart failure

Objective To study the changes of toll-like receptor 4(TLR4) expression in peripheral blood mononuclear cells(PBMCs) in the patients with chronic congestive heart failure(CCHF) after application of atorvastatin.Methods Eighty in-hospital CCHF patients were randomly divided into routine treatment group and atorvastatin group(n=40).All the patients received routine treatment of CCHF.Moreover,the patients in atorvastatin group took atorvastatin(20 mg/d) orally.Forty healthy subjects were regarded as normal control.TLR4 expression in PBMCs was measured by flow cytometry and serum tumor necrosis factor(TNF)-α was detected by ELISA before treatment and one month after treatment.The correlation between TLR4 expression and TNF-α level was analyzed.Results Before treatment,TLR4 expression in routine treatment group and atorvastatin group was significantly higher than that in normal control(both P<0.05) and positively correlated with TNF-α level(r=0.076,P<0.05).TLR4 expression and TNF-α level were significantly decreased one month after treatment(all P<0.05).Conclusion CCHF may be associated with enhanced expression of TLR4.Atorvastatin can significantly decrease TLR4 expression in PBMCs,which indicates that the anti-inflammatory effect caused by atorvastatin may be partially due to down-regulation of TLR4-mediated immune reaction.