摘要
目的探讨他汀类药物对急性冠脉综合征患者高密度脂蛋白（HDL）功能的影响。方法选取经临床及冠脉造影诊断的急性冠脉综合征患者80例，分为服用他汀组（35例）和未服用他汀组（45例）；选取同期经冠脉造影证实的非冠心病患者23例作为对照组。以患者血浆诱导巨噬细胞胆固醇外流，评估他汀类药物对胆固醇外流的影响；通过检测去除apoB血浆中的脂蛋白相关磷脂酶A2（LpPLA2）浓度，探讨他汀类药物对HDL抗氧化功能的影响。结果急性冠脉综合征患者胆固醇外流率较对照组显著降低[（18．77±5．94）％比（23．68±6．63）％，P=0．01]，但服用他汀组与未服用他汀组患者胆固醇外流率未见统计学差异[（18．19±5．85）％比（19．24±6．05）％，P=0．450]，且不受服用他汀种类药物种类的影响；服用他汀组患者比未服用他汀组患者血浆HDL—LpPLA2浓度有升高趋势，但耒见统计学差异[（10．08±5．54）ng／ml比（7．55±4．89）ng／ml，P=0．134]。结论急性冠脉综合征患者HDL促胆固醇外流功能减低，他汀类药物不能改善HDL经ABCAl途径的胆固醇外流功能，对高密度脂蛋白抗氧化功能具有一定增强趋势。
Objective To investigate the effect of statins on high density lipoprotein function in patients with acute coronary syndrome. Methods Patients diagnosed with acute coronary syndrome by clinical symptoms and coronary angiography （n=80） were divided into two groups according to whether they were taking statins （n= 35 ） or not （n=45）, patients without coronary heart disease confirmed by coronary angiography was taken as con- trois （n=23）, the cholesterol efflux capacity of different groups was measured. The concentration of lipoprotein as- sociated phospholipase A2 （LpPLA2） in apoB-deleted plasma was measured and known as HDL-LpPLA2, reflect- ing the antioxidative capacity of high-density lipoprotein. Results The cholesterol efflux capacity in patients with acute coronary syndrome was significantly lower than that in the control group [ （18.77%±5.94）% vs （23.68± 6.63 ）% ,P=0.001 ]. The cholesterol efflux capacity of patients taking statins had no statistical difference with whom not taking statins[ （18.19±5.85）% vs （19.24±6.05）%,P=0.450] ,no matter what kind of statins they were taking, HDL-LpPLA2 concentration had a rising trend between the two groups but didn＇t reach significant difference [（10.08±5.54）ng/ml vs （7.55±4.89）ng/ml,P=0.134]. Conclusion Cholesterol efflux capacity was impaired in patients with acute coronary syndrome, statins can not improve the ABCA1 cholesterol efflux, while had a certain enhancement trend in antioxidative capacity of high-density lipoprotein.
出处
《中国心血管病研究》
CAS
2016年第5期464-468,480,共6页
Chinese Journal of Cardiovascular Research
