他汀强化治疗对急性冠脉综合征MMP-9的影响

Changes of Serum MMP-9 and Prognosis in Patients with Acute Coronary Syndromes by Intensive Statins Treatment

目的研究早期他汀强化治疗对急性冠脉综合征患者基质金属蛋白酶-9和预后的影响。方法183例急性冠脉综合征患者随机分为他汀治疗组和对照组,入院第2天和治疗4周后分别测定基质金属蛋白酶-9(MMP-9)水平,并比较治疗30d主要终点事件(顽固性缺血状态、新近心肌梗死和死亡),同时测定血脂水平。另设正常对照组。结果①治疗前他汀治疗组和对照组血清MMP-9水平均较正常组明显增高(P<0.05)。②治疗组经阿托伐他汀治疗4周血清MMP-9水平较治疗前明显下降(P<0.01)。对照组4周后MMP-9水平无明显变化,与治疗组相比有高度显著性差别(P<0.01)。③阿托伐他汀治疗4周时血脂水平无明显变化;④治疗组与对照组治疗1个月时,两组终点事件发生率有显著性差别(P<0.05)。结论早期他汀强化治疗可减少急性冠脉综合征患者终点事件发生,显著改善急性冠脉综合症的预后。

Objective To study the influence of serum MMP - 9 and prognosis of acute coronary syndromes by intensive statin treatment. Methods 183 patients with acute coronary syndromes were randomized divided into intensive statin therapy and control groups , and normal control group was set up; Detect the serum MMP -9 at second day after hospitalization and treatment for 30 days, and so detect the blood lipids level as control. Study the 30 - day primary composite end point events （persistent myocardial ischaemic state, new onset myocardial infarction and death）. Results ①Before therapy, the serum of MMP -9 in intensive statin therapy and control groups were notably increasing than normal control group（ P 〈0.05）. ②The serum of MMP-9 in intensive statin therapy group significantly decreased after treatment with atorvastatin for 4 weeks （ P 〈 0.01 ）, while the control group have no significant changes after 4 weeks. It has a significant difference compare with two groups （ P 〈0.01 ）. ③Blood lipids levels have no significant change after treatment with atorvastatin for 4 weeks. ④Compared with the control group, end point events incidence of intensive statins therapy group significantly decreased after treatment with atorvastatin for 1 month （ P 〈 0.05 ）. Conclusion Early intensive atorvastatin treatment may reduce end point events, significantly improve prognosis in patients with ACS.