Tani Shigemasa, Nagao Ken, Anazawa Takeo, Kawamata Hirofumi, Iida Kiyoshi, Matsumoto Michiaki, Sato Yuichi, Hirayama Atsushi
Department of Cardiology, Nihon University Surugadai Hospital, Tokyo, Japan.
Atherosclerosis. 2008 Jun;198(2):360-5. doi: 10.1016/j.atherosclerosis.2008.02.007. Epub 2008 Feb 16.
Epidemiological studies have demonstrated that the peripheral blood leukocyte count could be used as a marker of the progression of atherosclerosis. Few data exist regarding the relationship between inhibition of the progression of coronary atherosclerosis and the anti-inflammatory effects of statins, especially the drugs' effects on the leukocyte count in patients with coronary artery disease. A 6-month prospective study was, therefore, conducted in 50 patients treated with pravastatin. The plaque volume, as assessed by volumetric analysis using intravascular ultrasound, reduced significantly by 14% (p<0.0001, vs. baseline) following the treatment, furthermore, a corresponding decrease of the leukocyte count (8.9%, p<0.01, vs. baseline) was also seen. No correlation was found between the change in the leukocyte count and any of the changes in the lipid levels; changes in either of these are known to be associated with the rate of progression of atherosclerosis. A multivariate regression analysis using other traditional risk factors and medications as covariates revealed that the decrease in the leukocyte count was an independent predictor of inhibition of the progression of coronary atherosclerosis. In conclusion, a reduction of the leukocyte count as one of the non-lipid-lowering effects of pravastatin may be a novel marker of regression of coronary atherosclerosis.
流行病学研究表明,外周血白细胞计数可作为动脉粥样硬化进展的标志物。关于抑制冠状动脉粥样硬化进展与他汀类药物抗炎作用之间的关系,尤其是这些药物对冠心病患者白细胞计数的影响,相关数据较少。因此,对50例接受普伐他汀治疗的患者进行了一项为期6个月的前瞻性研究。使用血管内超声通过体积分析评估的斑块体积在治疗后显著减少了14%(与基线相比,p<0.0001),此外,白细胞计数也相应下降(8.9%,与基线相比,p<0.01)。白细胞计数的变化与任何血脂水平变化之间均未发现相关性;已知这些变化中的任何一个都与动脉粥样硬化的进展速度有关。使用其他传统风险因素和药物作为协变量进行的多变量回归分析显示,白细胞计数的下降是抑制冠状动脉粥样硬化进展的独立预测指标。总之,白细胞计数的降低作为普伐他汀的非降脂作用之一,可能是冠状动脉粥样硬化消退的一个新标志物。