Chen Huan-qin, Tan Hong-yong, Yang Yi-wen, Qiu Lei, Liu Xiang-qun
Department of Geriatrics, Qi-Lu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, Shandong Province, 250012, PR China.
Heart Vessels. 2010 Mar;25(2):77-81. doi: 10.1007/s00380-009-1162-1. Epub 2010 Mar 26.
Acute coronary syndrome (ACS) is a clinical syndrome caused by acute myocardial ischemia and a severe stage of coronary atherosclerosis heart disease. The aim of this study was to clarify whether ramipril was a therapeutic agent against monocyte chemoattractant protein 1 (MCP-1), interleukin 18 (IL-18), and interleukin 10 (IL-10) in elderly patients with ACS. A total of 190 subjects including 72 elderly patients with ACS (78.1% male, mean age 67.12 +/- 5.06 years), 60 elderly patients with stable angina pectoris (76.9% male, mean age 68.00 +/- 4.52 years), and 58 healthy volunteers (77.8% male, mean age 65.96 +/- 4.18 years) were recruited into the study. Serum MCP-1, IL-10, and IL-18 were determined in 132 elderly patients by enzyme-linked immunosorbent assay (ELISA) before and after treatment with low doses of ramipril (2.5-5 mg/day), and were determined in 58 healthy volunteers. The levels of serum MCP-1 and IL-18 were much higher in elderly patients with ACS than those in elderly patients with SAP and healthy volunteers. After treating with ramipril, the levels of MCP-1 and IL-18 were decreased in elderly patients with ACS. Moreover, ramipril significantly increased serum IL-10 in elderly patients with ACS. Ramipril plays an important role in elderly patients with ACS. With decreasing MCP-1 and IL-18, it can ameliorate cytokine-associated cardiac damage. This study may provide a new recognition of angiotensin-converting enzyme inhibitor for the treatment of ACS.
急性冠状动脉综合征（ACS）是由急性心肌缺血引起的临床综合征，是冠状动脉粥样硬化性心脏病的严重阶段。本研究的目的是明确雷米普利是否为老年ACS患者单核细胞趋化蛋白1（MCP-1）、白细胞介素18（IL-18）和白细胞介素10（IL-10）的治疗药物。本研究共纳入190名受试者，包括72例老年ACS患者（男性占78.1%，平均年龄67.12±5.06岁）、60例老年稳定型心绞痛患者（男性占76.9%，平均年龄68.00±4.52岁）和58名健康志愿者（男性占77.8%，平均年龄65.96±4.18岁）。采用酶联免疫吸附测定（ELISA）法测定了132例老年患者在低剂量雷米普利（2.5-5mg/天）治疗前后血清MCP-1、IL-10和IL-18水平，并测定了58名健康志愿者的上述指标。老年ACS患者血清MCP-1和IL-18水平显著高于老年稳定型心绞痛患者和健康志愿者。雷米普利治疗后，老年ACS患者MCP-1和IL-18水平降低。此外，雷米普利显著提高了老年ACS患者血清IL-10水平。雷米普利在老年ACS患者中发挥重要作用。通过降低MCP-1和IL-18水平，可改善细胞因子相关的心脏损伤。本研究可能为血管紧张素转换酶抑制剂治疗ACS提供新的认识。
