大剂量阿托伐他汀对行PCI急性心肌梗死病人血EPCs动员和VEGF、TLR4表达水平的影响
Effect of high dose atorvastatin on blood EPCs mobilization,and expression levels of VEGF and TLR4 in AMI patients treated with PCI
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摘要: 目的：探讨大剂量阿托伐他汀对行经皮冠状动脉介入术（PCI）治疗急性心肌梗死（AMI）病人血内皮祖细胞（EPCs）动员和血管内皮生长因子（VEGF）、Toll样受体4（TLR4）表达水平的影响。方法：选择行急诊PCI的AMI病人100例随机分为大剂量组和常规剂量组，每组50例。另选取非器质性心脏病的病人50例作为对照组。检测并比较各组病人的EPCs动员、VEGF含量和TLR4表达水平。结果：治疗后，大剂量组EPCs细胞数量和VEGF水平高于常规剂量组（P<0.05~P<0.01），TLR4水平明显低于常规剂量组（P<0.01）。与治疗前相比，大剂量组EPCs细胞数量和VEGF水平明显升高（P<0.01），TLR4水平明显降低（P<0.01），常规剂量组TLR4水平明显降低（P<0.01），而EPCs细胞数量和VEGF水平无显著变化（P>0.05）。治疗后，常规剂量组与大剂量组病人恶性室性心律失常发生率、丙氨酸氨基转移酶升高率差异均无统计学意义（P>0.05）。结论：大剂量的阿托伐他汀可增加行PCI术病人外周血VEGF表达，动员骨髓EPCs参与修复损伤的血管内膜，降低病人外周血单核细胞TLR4表达，具有抑制炎症、稳定斑块的作用。
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关键词:
- 心肌梗死 /
- 经皮冠状动脉介入治疗术 /
- 血内皮祖细胞 /
- 阿托伐他汀
Abstract: Objective:To investigate the effects of high dose atorvastatin on blood endothelial progenitor cells(EPCs) mobilization,and expression levels of vascular endothelial growth factor(VEGF) and toll like receptor 4(TLR4) in acute myocardial infarction(AMI) patients treated with percutaneous coronary intervention(PCI).Methods:One hundred emergency patients with AMI were randomly divided into the high dose group and conventional dose group(50 cases each group),and 50 patients with non-organic heart disease were set as the control group.The levels of EPCs,VEGF and TLR4 in three groups were analyzed.Results:After treatment,the EPCs amount and VEGF level in high dose group were significantly higher than those in conventional dose group(P<0.05 to P<0.01),and the level of TLR4 in high dose group was significantly lower than that in conventional dose group(P<0.01).Compared with before treatment,the EPCs amount and VEGF level significantly increased(P<0.01),and the level of TLR4 significantly decreased in high dose group(P<0.01).Compared with before treatment,the level of TLR4 significantly decreased(P<0.01),and the changes of the EPCs amount and VEGF level were not obvious in conventional dose group(P>0.05).After tre atment,the differences of the incidence rate of MVA and increasing rate of alanine aminotransferase between high dose group and conventional dose group were not statistically significant(P>0.05).Conclusions:High dose atorvastatin can increase the VEGF expression,mobilize bone marrow EPCs to repair the vascular intima,reduce TLR4 expression in peripheral blood monocytes,and play a role in inhibiting inflammation and stabilizing plaque. -
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