行择期经皮冠状动脉介入治疗术的ACS患者TLR4表达水平及阿托伐他汀对其的影响
The expression of TLR4 in patients with ACS undergoing selective percutaneous coronary intervention and the effect of atorvastatin on it
徐凯 1金小辉 1王丽 1卢先本2
作者信息
- 1. 台州恩泽医疗中心(集团)浙江省台州医院 药剂科,浙江 台州 317000
- 2. 台州恩泽医疗中心(集团)浙江省台州医院 心血管内科,浙江 台州 317000
- 折叠
摘要
目的 分析急性冠状动脉综合征(Acute Coronary Syndrome,ACS)患者行择期经皮冠状动脉介入治疗(PCI)术后外周血单核细胞Toll 样受体4(TLR4)的表达水平与ACS 发生和冠脉病变程度的相关性,观察增加阿托伐他汀剂量治疗对TLR4 表达的影响.方法 选取台州恩泽医疗中心(集团)浙江省台州医院心血管内科2014年5月～2016年5月收治的100 例行择期PCI 术的ACS患者.将其随机分为对照组和实验组,对照组入院后予以阿托伐他汀20 mg/d 治疗,PCI 术后持续,1月后仍维持20 mg/d 剂量.实验组入院后予以阿托伐他汀40 mg/d 治疗,PCI 术后,1月后减量至20 mg/d.采用流式细胞检测仪对患者入院后、1 疗程治疗后外周血单核细胞TLR4 表达水平进行检测,并采用Gensini 评分系统对患者冠脉病变程度进行评分.同时选择体检健康者50 例作为正常组进行对比.结果 相较于体检正常组,ACS 患者外周血单核细胞T2组患者外周血单核细胞TLR4 表达水平、低密度脂蛋白胆固醇、总胆固醇水平明显降低,高密度脂蛋白胆固醇水平明显升高,差异均具有统计学意义( P< 0.01);同正常组相比,实验组外周血单核细胞Toll样受体4表达水平、总胆固醇、低密度脂蛋白胆固醇降低程度高于正常组,高密度脂蛋白胆固醇升高幅度较为明显,组间比较差异均具有统计学意义( P< 0.01).结论 ACS发生及病变程度与患者外周血单核细胞Toll样受体4表达水平增加具有一定相关性,增加阿托伐他汀使用剂量能够显著降低ACS患者PCI术后外周血单核细胞Toll4样受体表达水平.
Abstract
Objective To analyzethe expression level of peripheral blood mononuclear cell Toll like receptor 4(TLR4)in patients with acute coronary syndrome(ACS)undergoing elective percutaneous coronary intervention(PCI),and intensive atorvastatin on Toll like receptor 4 in clinical treatment.Methods 100 cases of patients with ACS were selected in our hospital from May 2014 to May 2016 were randomly divided into control group and experimental group,control group were given atorvastatin treatment after admission,20mg/d PCI postoperative continuous,after one month still maintain dose of 20mg/d.The experimental group were given atorvastatin treatment after admission,40mg/d,PCI postoperative continuous,after one month reduced to 20mg/d.After admission and a course of treatment,the expression level of peripheral blood mononuclear cells TLR4 was detected by flow cytometry and the Gensini scoring system on coronary lesion degree.At the same time,50 healthy subjects were selected as normal group.Results Compared with healthy subjects,the peripheral blood mononuclear cells TLR4 level in ACS patients has been significantly increased,and the level in patients with unstable angina pectoris is far lower than the level increased in patients with acute myocardial infarction,triple branch lesions groups were significantly higher than them in single and double branch lesion groups,the difference between the three obviously,with statistical significance(P<0.01); According to stepwise multiple linear regression and othercorrelation analysis showed that ACS category and the severity of coronary artery stenosis,coronary artery stenosis score were positively associated with the levels of TLR4(P<0.05); After treatment for one month,the levels of TLR4,the expression of low density lipoprotein cholesterol and total cholesterol levels were significantly lower,high density lipoprotein Cholesterol levels were significantly increased,the differences were statistically significant(P<0.01); compared with the normal group,the experimental group peripheral blood mononuclear cells of patients with Toll like receptor 4 expression level,total cholesterol,low density lipoprotein cholesterol level in the experimental group is higher than the normal group,high density lipoprotein cholesterol increased significantly,comparison between groups the differences were statistically significant(P<0.01).Conclusion The degree of lesions and the occurrence of acute coronary syndrome in patients with peripheral blood mononuclear cells of Toll like receptor 4 expression level increase has certain effect,increase the dosage of atorvastatin can significantly reduce the ACS after PCI in patients with peripheral blood mononuclear cells of patients with Toll4 like receptor expression.
关键词
ACS患者/TLR4表达水平/阿托伐他汀/治疗效果Key words
ACS patients/TLR4 expression level/atorvastatin/therapeutic effect引用本文复制引用
出版年
2017
NETL
NSTL
维普
万方数据