炎症标记、药物治疗和临床试验PPT课件.ppt

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1、InflammatoryMarkers,Pharmacotherapy,andClinicalTrialsPaulM.Ridker,M.D.,M.P.H.,andChristieM.Ballantyne,M.D.Isthereclinicalevidencethatinflammationcanbemodifiedbypreventivetherapies?hs-CRP,Aspirin,andRisksofFutureMI:Physicians'HealthStudyAdaptedfromRidkerPMetal.NEnglJMed19

2、97;336:973-979.©1997MassachusettsMedicalSociety.Allrightsreserved.QuartileofC-ReactiveProtein1234AspirinPlaceboRelativeRiskofMILow-DoseAspirinReducesThromboxaneB2butnotCRPSerumCRP(%ofBaseline)140120100806040200Placebo(n=11)FeldmanMetal.JAmCollCardiol2001;37:2036-2041.14

3、0120100806040200SerumThromboxane(%ofBaseline)ASA81mgqd(n=13)Placebo(n=11)ASA81mgqd(n=13)28Days31Days*p<0.001**ReductionofProinflammatoryCytokinesandCRPwithHigher-DoseAspirininPatientswithChronicStableAnginaIkonomidisIetal.JAmCollCardiol1999;100:793-798.Placebo(n=40)ASA3

4、00mg(n=40)PMCSF,pg/mL991(459-1476)843(501-1357)<0.05IL-6,pg/mL3.5(3.2-4.6)2.9(2.5-3.4)<0.05CRP,mg/mL1.4(0.54-4.05)1(0.5-3.1)<0.05ElevatedCRPLevelsinObesity:NHANES1988-1994VisserMetal.JAMA1999;282:2131-2135.NormalPercentwithCRP0.22mg/dLOverweightObeseEffectsofWeigh

5、tLossonCRPConcentrationsinObeseHealthyWomen83women(meanBMI33.8,range28.2-43.8kg/m2)placedonverylowfat,energy-restricteddiet(6.0MJ,15%fat)for12weeksBaselineCRPpositivelyassociatedwithBMI(r=0.281,p=0.01)CRPreducedby26%(p<0.001)Averageweightloss7.9kg,associatedwithchangeinC

6、RPChangeinCRPcorrelatedwithchangeinTC(r=0.240,p=0.03)butnotchangesinLDL-C,HDL-C,orglucoseAt12weeks,CRPconcentrationhighlycorrelatedwithTG(r=0.287,p=0.009),butnotwithotherlipidsorglucoseHeilbronnLKetal.ArteriosclerThrombVascBiol2001;21:968-970.EffectsofWeightLossinObeseWom

7、enonIL-6,TNF-,andCRPBastardJ-Petal.JClinEndocrinolMetab2000;85:3338-3342.pg/mLmg/LIL-6TNF-CRPBeforedietAfterverylowcaloriediet(meanBMIreduction2.1kg/m2;meanreductioninbodyfatmass4kg)p=0.05p=0.6p=0.14Effectsofn-3FattyAcidTherapyonLipidsandsCAMsPercentChangeAbeYetal.Art

8、eriosclerThrombVascBiol1998;18:723-731.TGTCsICAM-1sE-selectinAllPatientsDMPatients*****p<0.05Eff