瑞舒伐他汀干预前后急性冠状动脉综合征患者血清白细胞介素17的变化及意义

摘要

目的：探讨瑞舒伐他汀干预前后急性冠状动脉综合征（ACS）患者血清白细胞介素17（IL-17）的变化及意义。方法选取我院心血管内科收治的ACS患者48例（A组），另选取同时期我院收治的稳定性心绞痛患者30例（B组）。检测2组患者的血脂、高敏C反应蛋白、心肌酶以及冠状动脉病变支数并分析其与血清IL-17的相关性；用瑞舒伐他汀对A组患者进行干预治疗，对比干预前后4周2组患者血清IL-17水平的变化情况。结果治疗前A组患者血清IL-17水平显著高于B组[（34．41±6．37）ng/Lvs（15．18±3．11）ng/L，P＜0．05]；与治疗前比较，A组患者治疗4周后血清IL-17水平显著下降至（16．71±4．72）ng/L，差异有统计学意义（P＜0．05），治疗后2组患者血清IL-17水平比较，差异无统计学意义（P＞0．05）。多元回归分析显示，高敏C反应蛋白、肌钙蛋白、冠状动脉病变支数与血清IL-17水平呈正相关（P＝0．012，0．008，0．000）。结论ACS患者血清IL-17水平能够在一定程度上反映病情的严重程度，早期应用瑞舒伐他汀干预，可减轻机体炎性反应、降低血清IL-17水平，对稳定冠状动脉斑块、降低ACS的发病有重要意义。%Objective To study the significance of serum IL-17 level in patients with acute coronary syndrome (ACS ) before and after rosuvastatin treatment .Methods Forty-eight ACS patients served as group A and 30 stable angina pectoris patients served as group B in this study .T heir blood-lipid level and serum hs-CRP and myocardial enzyme levels were measured and the number of coronary artery branches with lesions was calculated .Their association with serum IL-17 level was analyzed .Patients in group A were treated with rosuvastatin .The serum IL-17 levels were compared in two groups before and 4 weeks after rosuvastatin treatment .Results The serum IL-17 level was significantly higher in group A than in group B before rosuvastatin treatment (34.41 ± 6 .37 ng/L vs 15 .18 ± 3 .11 ng/L ,P<0 .05) and significantly lower in group A 4 weeks after rosuvastatin treatment than before rosuvastatin treatment (16 .71 ± 4 .72 ng/L vs 34 .41 ± 6.37 ng/L ,P<0 .05) .No significant difference was found in serum IL-17 level between the two groups after rosuvastatin treatment (P>0 .05) .Multivariate regression analysis showed that the serum hs-CRP and troponin level and the number of coronary artery branches with lesions were positively related with the serum IL-17 level (P=0 .012 ,0 .008 ,0 .000) .Conclusion Serum IL-17 level in ACS patients can partly reflect the severity of ACS .Early treatment of ACS with rosuvas-tatin can reduce the inflammatory reactions and serum IL-17 level ,and is of great significance in stabilizing the coronary plaques and reducing the incidence of ACS .