阿托伐他汀治疗急性冠脉综合征对血浆MMP-9及GMP-140的影响

The effect of atorvastatin on serum level of matrix metalloprotease-9 and alpha-granule membrane protein in patients with acute coronary syndromes

目的探讨阿托伐他汀对急性冠脉综合征(ACS)患者血浆基质金属蛋白酶(MMP-9)及血小板α-颗粒膜蛋白(GMP-140)的影响。方法选择60例健康人做对照,200例ACS患者随机分为两组:常规治疗组(未服用任何调脂药物,n=80例)和阿托伐他汀组(10mg/d,n=120例)治疗1周,测定治疗前后MMP-9、GMP-140及血脂水平的变化。结果ACS患者血浆MMP-9、GMP-140水平显著高于健康对照组(P<0.01)。ACS两组治疗前后血脂各组成分的变化差异均无显著性(P>0.05),阿托伐他汀治疗后血浆MMP-9、GMP-140水平明显下降,与治疗前比较有统计学意义(P<0.01),但下降程度与TC(r=0.327,P=0.576;r=0.123,P=0.591),LDL-C(r=-0.312,P=0.921;r=-0.125,P=0.652)的变化无相关性。结论ACS患者早期给予阿托伐他汀强化干预,可明显减少细胞外基质的降解、抗血小板活化及改善内皮功能,对于ACS的临床预后有着重要的意义。

Objective To investigate the effect of early intervention by atorvastatin on serum level of matrix metalloprotease-9 and alpha-granule membrane protein in patients with acute coronary syndromes （ACS）. Methods There were 200 patients with ACS and 60 cases of age-matched healthy individuals as control. 200 patients with ACS were randomly divided into two groups： conventional therapy group （n=80） treated without lipid-lowering drugs,atorvastatin group （n=120） treated with 10mg/d atorvastatin for one week. Before and after treatment the serum level of MMP-9, GMP-140 and lipids were detected. Results There was a significant difference in serum level of MMP-9 and GMP-140 between ACS group and healthy control group （P〈0.01）. No changes of lipids levels were observed in any ACS group before and after treatment （P〉0.05）, but the levels of MMP-9 and GMP-140 in atorvastatin group decreased significantly and had statistical difference （P〈0.01）, and no relation between the decrease percent of MMP-9 or GMP-140 and that of TC （r=-0.327, P=0.576; r=-0.123, P=0.591） or LDL-c（r=-0. 312, P=0.921; r=-0.125,P=0.652）. Conclusion The early intervention with atorvastatin for the ACS patients can decrease breakdown of matrix collagen, inhibit platelet activation and improve the function of vascular endothelium, and it may have a beneficial effect on clinical treatment.