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目的验证OX40L在冠心病患者及正常对照血浆中的变化,探讨不同剂量阿托伐他汀早期干预治疗对急性冠脉综合症(ACS)患者血浆炎症指标OX40L及超敏C反应蛋白(hs-CRP)水平的影响。方法急性冠脉综合症(ACS)60例,稳定型心绞痛20例(SA),非冠心病患者20例(C)。分别测定以上各组患者入院时的血浆OX40L及hs-CRP水平。将ACS患者随机分成阿托伐他汀10mg/d组(A组)和40mg/d组(B组),疗程均为7～10d,第8d测定两组ACS患者血浆OX40L及超敏CRP的水平。结果⑴ACS组血浆OX40L水平高于正常组(P<0.05),略高于SA组,差异无统计学意义。三组hs-CRP水平比较,ACS组明显高于正常组和SA组(P<0.05);⑵阿托伐他汀治疗1周后A、B两组血浆OX40L及hs-CRP水平均有所下降,A组患者血浆hs-CRP水平治疗前后差异有统计学意义(P<0.05),OX40L治疗前后差异无统计学意义,B组hs-CRP及OX40L治疗前后均有统计学意义。将A、B两组治疗前后的变化值进行比较,OX40L与hs-CRP降低幅度均有差别,且差别有统计学意义(P<0.05),B组较A组作用更明显。⑶ACS患者血浆OX40L与hs-CRP之间呈正相关(r=0.52,P<0.001)。结论 ACS患者血浆OX40L、hs-CRP水平增高,早期阿托伐他汀治疗可降低ACS患者OX40L及hs-CRP水平,且不同剂量阿托伐他汀对于OX40L、hs-CRP会产生不同的影响,40mg/d抗炎作用强于10mg/d,ACS患者早期应用大剂量的他汀类强化治疗可能使患者获益更大。
Objective To investigate the changes of plasma OX40L and hs-CRP in patients with acute coronary syndrome (ACS) after different dosages of atorvastatin intervention in patients with coronary heart disease and normal controls. Horizontal impact. Methods 60 cases of acute coronary syndrome (ACS), 20 cases of stable angina pectoris (SA) and 20 cases of non-coronary heart disease (C). The levels of plasma OX40L and hs-CRP in admission to the above groups were measured respectively. The ACS patients were randomly divided into atorvastatin 10mg / d group (group A) and 40mg / d group (group B) for 7-10 days. On the 8th day, the levels of plasma OX40L and hypersensitive CRP in both groups were measured. Results (1) The level of plasma OX40L in ACS group was higher than that in normal group (P <0.05), slightly higher than that in SA group, the difference was not statistically significant. The level of hs-CRP in the three groups was significantly higher than that in the normal group and the SA group (P <0.05). (2) The levels of plasma OX40L and hs-CRP in A and B groups decreased at 1 week after atorvastatin treatment, The plasma hs-CRP level in group A was significantly different before and after treatment (P <0.05). There was no significant difference between before and after OX40L treatment. The levels of hs-CRP and OX40L in group B were statistically significant before and after treatment. Comparing the changes of A and B before and after treatment, there was a significant difference between OX40L and hs-CRP (P <0.05). The effect of B on A group was more obvious. There was a positive correlation between plasma OX40L and hs-CRP in patients with ACS (r = 0.52, P <0.001). Conclusion The plasma levels of OX40L and hs-CRP are increased in patients with ACS. Early atorvastatin treatment can reduce the levels of OX40L and hs-CRP in patients with ACS. Different doses of atorvastatin have different effects on OX40L and hs-CRP, while 40mg / d anti-inflammatory effect is stronger than 10mg / d, ACS patients early high-dose statin therapy may benefit patients more.