| Background：Unstable angina and Non-ST segment elevation myocardial infarction(NSTEMI) belong Acute cornary syndrome(ACS), is a critical type of coronary heartdisease. UA is the basis of the incidence of coronary plaque instability secondary topathological changes, so that regional myocardial blood flow was significantly reduced,such as plaque hemorrhage, bleeding fissures plaque fibrous cap, plaque surface ofplatelet aggregation and (or) to stimulate coronary spasm, leading to ischemia increased.A large number of previous studies have shown that the incidence of UA, progress andafter healing process of the body showed a strong oxidative stress. Increasing body ofreactive oxygen (ROS) are the most important factors are responsible for oxidativestress, nicotinamide adenine dinucleotide phosphate oxidase (NADPH oxidase) iscatalyzed ROS generation cardiovascular system the major enzyme system, wherein theenzyme is the most important ph22phoxcatalytic subunit. Adiponectin (APN) is acardiovascular protective factor, with a significant anti-oxidative stress.2004began in Italy in the multi-center, prospective, randomized, controlled clinicalstudies: Application angioplasty study of atorvastatin to reduce myocardial injury(ARMYDA) and acute coronary syndrome (ACS) angioplasty in patients withatorvastatin to reduce myocardial injury (ARMYDA-ACS) showed that the past is nolong-term statin drugs stable or unstable angina, PCI surgery before giving large dosesof atorvastatin (12hours before surgery taking atorvastatin80mg,2hours beforesurgery append40mg), can significantly improve the prognosis, especially in patientscan significantly reduce perioperative myocardial infarction incidence. Due to theshort-term high-dose atorvastatin application does not have a significant effect on bloodlipids, thus, can be sure of this cardiac protection of atorvastatin is through therealization of the role in regulating lipid outside (eg, oxidative stress, inflammatoryprotect endothelial function, plaque stabilization and so on); thus encourage people tolook for mechanisms to further benefit from statin lipid-lowering effect of statins outside.Objective：Observed a single large dose of atorvastatin in patients with unstable anginaplasma adiponectin and leukocyte ph22phoxmRNAexpression.Methods: Select from April2012to June2013in Dalian University AffiliatedZhongshan Hospital,81cases of patients with UA and coronary angiography isclinically proven, male46cases,35females, aged47-78years, mean (62±13.0) years;unstable angina and all cases were consistent with WHO diagnostic criteria. Select thesame period in our department coronary angiography or coronary CT negative results (n=46) as a control group of non-CHD hospitalization row, including24males and22females, aged45-73years, mean (59±11.0years). All patients underwent ECG andcardiac ultrasound examination, and complete the admission glucose, lipids, enzymes,and liver and kidney function and other biochemical parameters (by the hospitallaboratory completed) within24hours, and all subjects complete clinical data. The81UA patients were randomly divided into80mg atorvastatin intervention group (41cases),20mg atorvastatin conventional control group (40cases); non-coronary heartdisease in the control group (46cases), were not taking atorvastatin; blood drawn12hours after dosing5ml, separation of plasma and leukocyte spare, plasma adiponectinwere measured and blood cell ph22phoxmRNA levels. By enzyme-linkedimmunosorbent assay (ELISA) plasma APN levels; using RT-PCR assay in peripheralblood leukocytes ph22phoxmRNAexpression levels.Result：80mg atorvastatin intervention group plasma APN (7.99±0.75μg/ml) and20mgatorvastatin group (6.87±0.68μg/ml) compared to the somewhat increased, thedifference was statistically significant (P <0.05); but were significantly lower than thecontrol group of non-coronary heart disease (13.56±0.93μg/ml), with statisticalsignificance (P <0.05).80mg atorvastatin intervention group patients leukocyte ph22phoxmRNArelative expression levels (0.3613±0.029) compared to20mg atorvastatin groupwas significantly lower (0.6423±0.031), the difference was statistically significant (P<0.05); but two group were significantly higher than the control group of non-coronaryheart disease (0.1416±0.035), with a significant difference (P <0.05). Conclusion：High-dose atorvastatin can be reduced by leukocyte ph22phoxmRNAexpression levels in peripheral blood plasma APN elevated levels of unstable anginapatients, and thus exert anti-oxidative stress, reduce cardiovascular system damage. |
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