吡格列酮对非糖尿病急性冠脉综合征患者冠脉支架植入术后炎性反应抑制作用.docVIP

吡格列酮对非糖尿病急性冠脉综合征患者冠脉支架植入术后炎性反应抑制作用 　　[摘要] 目的 观察吡格列酮（PIO）对非糖尿病急性冠脉综合征（ACS）患者冠脉支架植入术后炎性反应的抑制作用。 方法 选择2007年10月～2008年12月在西安交通大学第一附属医院接受冠脉支架植入术的ACS患者78例，将所有患者随机分为治疗组（38例）和对照组（40例）。在PCI术及常规治疗的基础上，治疗组给予PIO治疗，对照组给予安慰剂治疗。两组患者均治疗12周，分别于治疗前及治疗12周后采用酶联免疫吸附测定（ELISA）法检测两组患者血清肿瘤坏死因子（TNF）-α、基质金属蛋白酶（MMP）-9、可溶性CD40配体（sCD40L）和可溶性CXC趋化因子配体（sCXCL）-16的变化，流式细胞术检测CD14+单核细胞TLR-4受体表达，Real-time PCR检测单个核细胞TLR-4 mRNA表达。 结果 治疗12周后，治疗组血清MMP-9、sCXCL-16、sCD40L与TNF-α水平明显低于对照组（P 0.05），同时CD14+单核细胞表面TLR-4受体以及单个核细胞TLR-4 mRNA表达也明显少于对照组（P 0.05）。 结论 PIO能够通过干预单个核细胞TLR-4表达降低非糖尿病ACS患者冠脉支架植入术后的炎性反应，可能与其抑制支架后再狭窄有关。 　　[关键词] 吡格列酮；急性冠脉综合征；炎性反应；冠脉支架植入术 　　[中图分类号] R541.4 [文献标识码] A [文章编号] 1674-4721（2016）08（c）-0137-04 　　[Abstract] Objective To observe the inhibitory effect of Pioglitazone （PIO） on inflammation after intracoronary stent implantation in non-diabetic patients with acute coronary syndrome （ACS）. Methods A total of 78 non-diabetic patients with ACS undergoing intracoronary stent implantation in the First Affiliated Hospital of Xian Jiaotong University from October 2007 to December 2008 were enrolled and randomly assigned into treatment group （38 cases） and control group （40 cases）. On basis of PCI and conventional treatment， the treatment group was given PIO， the control group was given placebo. Both groups were treated for 12 weeks. The changes of serum tumor necrosis factor （TNF）-α， matrix metalloproteinase （MMP）-9， soluble CD40 ligand （sCD40L） and soluble CXC chemokine ligand （sCXCL）-16 before treatment and after treatment for 12 weeks were detected by enzyme-linked immunosorbent assay （ELISA）， the flow cytometry was used to detect the expression of TLR-4 receptor in CD14+ monocytes， real-time PCR was used to detect the expression of TLR-4 mRNA in mononuclear cells. Results After treatment for 12 weeks， the levels of serum MMP-9， sCXCL-16， sCD40L and TNF-α in the treatment group were significantly lower than those of control group （P 0.05）， and the expression of TLR-4 receptor in CD14+ monocytes