Tani Shigemasa, Nagao Ken, Anazawa Takeo, Kawamata Hirofumi, Furuya Shingo, Takahashi Hiroshi, Iida Kiyoshi, Matsumoto Michiaki, Washio Takehiko, Kumabe Narimichi, Hirayama Atsushi
Department of Cardiology, Nihon University, Surugadai Hospital, Tokyo, Japan.
Am J Cardiol. 2009 Aug 15;104(4):464-9. doi: 10.1016/j.amjcard.2009.04.009. Epub 2009 Jun 24.
The purpose of this study was to clarify the relation between differential leukocyte counts and inhibition of the development of coronary atherosclerosis in patients with coronary artery disease. A 6-month prospective study was conducted in 84 patients treated with pravastatin. Plaque volume, as assessed by volumetric analysis using intravascular ultrasound, decreased significantly by 12.6% (p <0.0001 vs baseline) after treatment; furthermore, a corresponding decrease of total leukocyte count (8.9%, p <0.01 vs baseline) was seen. Change in plaque volume was correlated with changes in monocyte (r = 0.35, p = 0.002) and lymphocyte (r = 0.25, p = 0.03) counts but not with changes in neutrophil, eosinophil, or basophil counts. In a multivariate regression analysis with changes in serum lipids, traditional risk factors, and medications as covariates, the decrease in monocyte count was identified as an independent predictor of coronary plaque regression (beta coefficient 0.313, 95% confidence interval 0.089 to 0.353, p = 0.0014). No correlation was found between change in monocyte count and changes in any other lipid levels. This study demonstrated that monocyte count was the only leukocyte type significantly and independently associated with coronary atherosclerotic regression, even after adjustment for changes in any lipid levels. In conclusion, the decrease in monocyte count as a nonlipid-lowering effect of statins may be used as a novel marker of coronary atherosclerotic regression.
本研究的目的是阐明冠心病患者白细胞分类计数与冠状动脉粥样硬化发展抑制之间的关系。对84例接受普伐他汀治疗的患者进行了为期6个月的前瞻性研究。使用血管内超声通过容积分析评估的斑块体积在治疗后显著降低了12.6%（与基线相比，p<0.0001）；此外，总白细胞计数相应降低了8.9%（与基线相比，p<0.01）。斑块体积的变化与单核细胞（r = 0.35，p = 0.002）和淋巴细胞（r = 0.25，p = 0.03）计数的变化相关，但与中性粒细胞、嗜酸性粒细胞或嗜碱性粒细胞计数的变化无关。在以血脂变化、传统危险因素和药物作为协变量的多变量回归分析中，单核细胞计数的降低被确定为冠状动脉斑块消退的独立预测因素（β系数0.313，95%置信区间0.089至0.353，p = 0.0014）。未发现单核细胞计数变化与任何其他血脂水平变化之间存在相关性。本研究表明，即使在调整任何血脂水平变化后，单核细胞计数也是唯一与冠状动脉粥样硬化消退显著且独立相关的白细胞类型。总之，作为他汀类药物非降脂作用的单核细胞计数降低可作为冠状动脉粥样硬化消退的新标志物。
