中国危重病急救医学
中國危重病急救醫學
중국위중병급구의학
CHINESE CRITICAL CARE MEDICINE
2010年
11期
663-665
,共3页
方玉强%何多芬%杨成明%王旭开%曾春雨%王红勇%傅春江%石伟彬%张晔
方玉彊%何多芬%楊成明%王旭開%曾春雨%王紅勇%傅春江%石偉彬%張曄
방옥강%하다분%양성명%왕욱개%증춘우%왕홍용%부춘강%석위빈%장엽
冠心病%内皮脂肪酶%辛伐他汀%拜阿司匹林
冠心病%內皮脂肪酶%辛伐他汀%拜阿司匹林
관심병%내피지방매%신벌타정%배아사필림
Coronary artery disease%Endothelial lipase%Simvastatin%Aspirin
目的 了解调脂治疗和抗血小板治疗对冠心病患者内皮脂肪酶(EL)表达的影响,进一步探讨EL在冠心病中的作用.方法 将157例冠心病患者按临床表现和冠状动脉(冠脉)造影结果分为3组:对照组41例,有1项以上冠心病危险因素,但冠脉狭窄程度＜30%;稳定型心绞痛(SAP)组55例;急性冠状动脉综合征(ACS)组61例.在禁用调脂药和阿司匹林2周后取血查EL阳性细胞率,均给予患者辛伐他汀和(或)拜阿司匹林,如出现并发症或不能依从者停药,6个月后复查EL阳性细胞率.结果 除对照组单用拜阿司匹林外,各组患者不论单用辛伐他汀或拜阿司匹林,还是两药联用,EL阳性细胞率均显著下降[单用辛伐他汀对照组:(3.93±0.87)%比(5.28±1.05)%,SAP组:(8.16±2.11)%比(15.12±2.53)%,ACS组:(13.93±3.22)%比(38.44±4.36)%;单用拜阿司匹林SAP组:(10.57±4.07)%比(14.66±2.29)%,ACS组:(18.28±5.14)%比(40.27±3.96)%;联合用药对照组:(3.13±0.87)%比(5.33±1.25)%,SAP组:(5.68±2.20)%比(14.89±2.15)%,ACS组:(7.81±3.96)%比(39.27±5.17)%,P＜0.05或P＜0.01].结论 调脂治疗和抗血小板治疗能有效抑制内皮细胞表达EL,提示EL参与了冠心病的发病过程.
目的 瞭解調脂治療和抗血小闆治療對冠心病患者內皮脂肪酶(EL)錶達的影響,進一步探討EL在冠心病中的作用.方法 將157例冠心病患者按臨床錶現和冠狀動脈(冠脈)造影結果分為3組:對照組41例,有1項以上冠心病危險因素,但冠脈狹窄程度＜30%;穩定型心絞痛(SAP)組55例;急性冠狀動脈綜閤徵(ACS)組61例.在禁用調脂藥和阿司匹林2週後取血查EL暘性細胞率,均給予患者辛伐他汀和(或)拜阿司匹林,如齣現併髮癥或不能依從者停藥,6箇月後複查EL暘性細胞率.結果 除對照組單用拜阿司匹林外,各組患者不論單用辛伐他汀或拜阿司匹林,還是兩藥聯用,EL暘性細胞率均顯著下降[單用辛伐他汀對照組:(3.93±0.87)%比(5.28±1.05)%,SAP組:(8.16±2.11)%比(15.12±2.53)%,ACS組:(13.93±3.22)%比(38.44±4.36)%;單用拜阿司匹林SAP組:(10.57±4.07)%比(14.66±2.29)%,ACS組:(18.28±5.14)%比(40.27±3.96)%;聯閤用藥對照組:(3.13±0.87)%比(5.33±1.25)%,SAP組:(5.68±2.20)%比(14.89±2.15)%,ACS組:(7.81±3.96)%比(39.27±5.17)%,P＜0.05或P＜0.01].結論 調脂治療和抗血小闆治療能有效抑製內皮細胞錶達EL,提示EL參與瞭冠心病的髮病過程.
목적 료해조지치료화항혈소판치료대관심병환자내피지방매(EL)표체적영향,진일보탐토EL재관심병중적작용.방법 장157례관심병환자안림상표현화관상동맥(관맥)조영결과분위3조:대조조41례,유1항이상관심병위험인소,단관맥협착정도＜30%;은정형심교통(SAP)조55례;급성관상동맥종합정(ACS)조61례.재금용조지약화아사필림2주후취혈사EL양성세포솔,균급여환자신벌타정화(혹)배아사필림,여출현병발증혹불능의종자정약,6개월후복사EL양성세포솔.결과 제대조조단용배아사필림외,각조환자불론단용신벌타정혹배아사필림,환시량약련용,EL양성세포솔균현저하강[단용신벌타정대조조:(3.93±0.87)%비(5.28±1.05)%,SAP조:(8.16±2.11)%비(15.12±2.53)%,ACS조:(13.93±3.22)%비(38.44±4.36)%;단용배아사필림SAP조:(10.57±4.07)%비(14.66±2.29)%,ACS조:(18.28±5.14)%비(40.27±3.96)%;연합용약대조조:(3.13±0.87)%비(5.33±1.25)%,SAP조:(5.68±2.20)%비(14.89±2.15)%,ACS조:(7.81±3.96)%비(39.27±5.17)%,P＜0.05혹P＜0.01].결론 조지치료화항혈소판치료능유효억제내피세포표체EL,제시EL삼여료관심병적발병과정.
Objective To investigate the effects of lipid-modulation and antiplatelet treatment on the expression of endothelial lipase (EL) of patients with coronary artery disease (CAD), and investigate the role of EL in the development of CAD.Methods One hundred and fifty-seven cases were divided into three groups according to clinical manifestations and the results of coronary artery angiography: control group (n=41) with more than one risk factors of CAD and the vessel lesions was <30%; stable angina pectoris (SAP)group (n=55); acute coronary syndrome (ACS) group (n= 61).The EL positive cell rate was measured 2 weeks after cessation of lipid-sodulation and aspirin treatment, and 6 months after treatment with simvastatin and/or aspirin.The drug was ceased for the complications or not tolerance for the treatment.Results Except the patients in control group with aspirin treatment, the EL positive cell rate was significantly decreased among other groups[control group with simvastatin: (3.93 ± 0.87) % vs.(5.28 ±1.05)%, SAP group: (8.16±2.11)% vs.(15.12±2.53)%, ACS group: (13.93±3.22)% vs.(38.44±4.36)%; SAP group with aspirin: (10.57±4.07)% vs.(14.66±2.29)%, ACS group: (18.28±5.14)%vs.(40.27±3.96)%; control group with aspirin and simvastatin: (3.13±0.87)% vs.(5.33± 1.25)%,SAP group: (5.68±2.20)% vs.(14.89±2.15)%, ACS group: (7.81±3.96)% vs.(39.27±5.17)%,P<0.05 or P< 0.01].Conclusion The treatment with lipid-modulation and/or antiplatelet drug may significantly decrease the expression of EL, implying that EL participates in the progression of CAD.
