目的:探讨负荷剂量瑞舒伐他汀对不稳定性心绞痛患者PCI围术期CD4T淋巴细胞程序性细胞死亡因子4(PDCD4)表达的影响。方法选择入住我院不稳定性心绞痛患者92例,随机分为负荷剂量瑞舒伐他汀组(负荷剂量组,术前2d给予20mg/d,术后10mg/d)46例和常规剂量瑞舒伐他汀组(常规剂量组,术前2d、术后均10mg/d)46例。采用免疫磁珠法筛选出CD4T淋巴细胞,荧光定量PCR检测PDCD4mRNA表达;蛋白免疫印迹法检测PDCD4蛋白相对表达量;酶联免疫法检测血清TNF-α水平。结果与PCI前比较,负荷剂量组PCI后PDCD4mRNA和PDCD4蛋白相对表达量明显降低(P<0.05)。PCI后常规剂量组较负荷剂量组TNF-α水平明显升高[(14.62±2.45)ng/Lvs(9.51±1.93)ng/L,P<0.05]。结论负荷剂量瑞舒伐他汀可以通过抑制CD4T淋巴细胞PDCD4的表达,从而减少PCI术后心肌的炎性反应。
Objective To study the effect of loading dose rosuvastatin on PDCD4 expression in unstable angina pectoris patients undergoing perioperative PCI .Methods Ninety-two unstable angina pectoris patients admitted to our hospital were randomly divided into loading dose rosuvastatin treatment group and conventional dose rosuvastatin treatment group (46 in each group) .Patients in loading dose rosuvastatin treatment group were given 20 mg rosuvastatin daily before PCI and 10 mg rosuvastatin daily after PCI while those in conventional dose rosuvastatin treatment group were given 10 mg rosuvastatin daily before and after PCI .Circulating CD4 T lymphocytes were isolated using the magnetic cell sorting system .Expression of PDCD4 mRNA and protein was detected by RFQ-PCR and Western blot ,respectively .Serum TNF-αlevel was measured by ELISA . Results The expression levels of PDCD4 mRNA and protein were significantly lower in loading dose rosuvastatin treatment group after PCI than before PCI (P〈0 .05) .The serum TNF-α level was significantlt higher in conventional dose rosuvastatin treatment group than in loading dose rosuvastatin treatment group (14 .62 ± 2 .45 ng/L vs 9 .51 ± 1 .93 ng/L ,P〈 0 .05) .Conclusion Loading dose rosuvastatin treatment can reduce the inflammatory reactions in myocardium after PCI by inhibiting the PDCD4 expression in CD4 T lymphocytes .