罗格列酮对冠心病合并2型糖尿病患者MMP的影响

Effect of PPARγ-activator rosiglitazone treatment on MMP level in coronary artery disease patient with type 2 diabetic

目的:研究罗格列酮治疗冠心病合并2型糖尿病患者时血清基质金属蛋白酶(MMP)-2、9的变化,以探讨罗格列酮减少动脉粥样硬化(AS)炎症反应、稳定斑块的作用机制。方法:选取冠状动脉造影证实的冠心病患者62例,其中单纯冠心病者34例,合并2型糖尿病者28例,两组均给予血管紧张素转化酶抑制剂、硝酸脂类、抗血小板等常规治疗,合并2型糖尿病者给予口服罗格列酮4mg,2次/d,共12周;比较两组间及治疗前、后MMP-2及9含量变化。结果:与单纯冠心病患者比,冠心病合并2型糖尿病患者血浆中MMP-2及MMP-9水平明显升高(P<0.01);经罗格列酮治疗12周后血清MMP-2、9水平较治疗前明显降低(P<0.01)。结论:罗格列酮可降低冠心病合并糖尿病患者血清MMP-2及9水平,从而可减少冠状动脉粥样斑块基质成分的降解和炎症反应,起到稳定动脉粥样硬化斑块的作用。

Objective： To investigate the matrix metalloproteinase （MMP） levels in coronary artery disease （CAD） patients with or without diabetic. Methods： The 28 CAD patients with diabetic received rosiglitazone 4 mg （twice daily） above routine therapy of CAD and 34 CAD patients received routine therapy of CAD alone for 12 weeks. The level of MMP-2 and 9 were detected before and after treatment. Results： Compared with CAD patients without diabetics, the serum MMP-2 and -9 levels were significantly higher in CAD patients with type 2 diabetic （P〈0.01）. Rosiglitazone treatment significantly reduced MMP-9 levels after 4 weeks （P〈0.01）, and levels sustained until the end of the study （12 weeks）. Conclusion： The MMP-2 and 9 levels increased in CAD patients with type 2 diabetic, and treatment of rosiglitazone may significantly reduces MMP-2, 9 levels, so it may has anti-inflammatory and potential antiatherogenic effects.