小剂量辛伐他汀对心肾综合征患者补体水平及补体受体表达影响.docVIP

小剂量辛伐他汀对心肾综合征患者补体水平及补体受体表达影响 　　[摘要] 目的 观察心肾综合征（CRS）患者服用小剂量辛伐他汀后血清补体C3、C4水平及外周血单核细胞Ⅰ型（CR1）、Ⅱ型（CR2）补体受体mRNA表达的变化。 方法 随机入选2012年1～12月在南京市胸科医院门诊和病房住院的CRS患者56例，根据NYHA心功能分级进行心功能分级，根据简化的MDRD公式计算估计的肾小球滤过率。入选对象每晚睡前服用辛伐他汀10 mg，连续服用8周。入选后次日清晨及治疗第8周清晨抽取空腹静脉血，全自动生化分析仪测定血清C3、C4水平；采集外周静脉血提取外周血单个核细胞，提取总RNA并行RT-PCR检测CR1及CR2 mRNA的表达。 结果 CRS患者血清C3水平治疗后较治疗前降低[（1.14±0.35）和（1.22±0.31）g/L，P 0.05]，外周血?魏讼赴?CR1 mRNA治疗后较治疗前表达增强（0.76±0.10和0.70±0.11，P 0.05）。 结论 CRS患者服用小剂量辛伐他汀后，血清C3水平降低及外周血单核细胞CR1核酸表达上调可能共同参与患者心肾功能的改善。 　　[关键词] 辛伐他汀；心肾综合征；心功能；肾功能；C3；Ⅰ型补体受体 　　[中图分类号] R541 [文献标识码] A [文章编号] 1673-7210（2017）09（b）-0094-04 　　Department of Cardiology， Nanjing Chest Hospital， Jiangsu Province， Nanjing 210029， China 　　[Abstract] Objective To investigate the effects of low-dose Simvastatin on serum levels of C3， C4 and mRNA levels of type Ⅰ （CR1） and Ⅱ （CR2） complement receptor in patients with cardiorenal syndrome （CRS）. Methods Totally 56 patients with CRS were enrolled from January to December in 2012 and treated with Simvastatin （10 mg once per night） for 8 weeks. The serum levels of C3 and C4 were measured. Peripheral blood mononuclear cells were extracted from patients before and after treatment with Simvastatin. RT-PCR was performed to detect the mRNA expression of CR1 and CR2. The left ventricular ejection fraction was determined by Doppler spectrum analysis. Results After therapy， the mean levels of serum C3 was significantly decreased in patients with CRS [（1.14±0.35） vs （1.22±0.31） g/L， P 0.05]. Contrarily， the mean mRNA level of CR1 increased after therapy （0.76±0.10 vs 0.70±0.11， P 0.05）. Conclusion The down-regulation of serum level of C3 as well as up-regulation of CR1 after treatment with low-dose Simvastatin is probably associated with improvement of heart and renal function in patients with CRS. 　　[Key words] Simvastatin； Cardiorenal syndrome； Heart function； Renal function； Complement 3； Type Ⅰ complement receptor 　　心力衰竭是各种致病因素作用于心脏严重影响心脏功能的结果，是各种器质性心脏病的终末阶段。随着社会老年化，部分心力衰竭患者中出现