不同剂量阿托伐他汀对糖尿病合并冠心病患者外周血单个核细胞 NF－κB 活性的影响

摘要

目的：探讨阿托伐他汀对糖尿病合并冠心病患者外周血单个核细胞NF－κB活性的影响。方法150例患者根据CAG结果及临床病史分为对照组（A组）30例、冠心病组（B组）60例、糖尿病合并冠心病组（C组）60例，再将B组和C组按数字表法随机分为他汀10 mg亚组和40mg 亚组各30例，采用酶联免疫吸附法、乳胶增强透射免疫比浊法和流式细胞仪方法检测各组患者治疗前后外周血白细胞介素－6（IL－6）、高敏C反应蛋白（hs－CRP）水平和单个核细胞NF－κB活性。结果（1）与A组比较，B组和C组外周血单个核细胞NF－κB及IL－6、hs－CRP水平活性均不同程度升高，他汀治疗后NF－κB活性及IL－6、hs－CRP水平下降，且他汀40 mg亚组较他汀10 mg亚组下降更显著（P ＜0．05或P ＜0．01）；（2）患者单个核细胞NF－κB活性与外周血IL－6、hs－CRP水平呈正相关（ r ＝0．550，0．675， P ＜0．01）。结论糖尿病合并冠心病患者外周血单个核细胞NF－κB明显激活，高剂量他汀可显著抑制体内炎性反应。%Objective To investigate the effect of atorvastain on nuclear factor kappa B activity in patients with dia-betes mellitus (DM) combined coronary heart disease (CHD).Methods There were one hundred and fifty patients, thirty of them were divided into control group ( group A) , sixty of them were divided into coronary heart disease group ( group B) , and the last sixty of them were divided into diabetes mellitus combined coronary heart disease group (group C).The patients of group C and group B were randomly divided into two subgroups:10 mg of atorvastatin group and 40 mg of atorvastatin group. The activity of nuclear factor kappa B and level of IL-6, hs-CRP were tested by flow cytometry method, enzyme linked immu-nosorbent method and latex enhanced transmission cells immune turbidimetric method.Results ( 1 ) Compared with group A, the level of IL-6, hs-CRP and activity of NF-κB in group B and group C were increased.After treated with atorvastain,the level of IL-6,hs-CRP and activity of NF-κB were decreased,and 40mg atorvastain subgroup declined more significantly ( P <0.05 or P <0.01).(2) There was positive correlation between NF-κB and IL-6, and between NF-κB and hs CRP ( r =0.550, r =0.675,P <0.01) .Conclusion The activity of NF-κB in patients with diabetes mellitus and coronary heart di-sease was higher, being treated with high dose of atorvastatin can significantly inhibit the inflammatory response in vivo.