高脂血症患者颈动脉内中膜IBS值和血清MMP-9及辛伐他汀的干预研究

Quantitative ultrasonic integrated backscatter of the intima-media complex,serum level of matrix metalloprotease-9 and simvastatin in hyperlipemia patients

目的:探讨高脂血症患者颈动脉内中膜背向散射积分(integrated backscatter,IBS)的改变及其与血清基质金属蛋白酶-9(matrix metalloprotease-9,MMP-9)的关系,并观察短期辛伐他汀治疗对颈动脉内中膜IBS值及血清MMP-9的影响。方法:高脂血症患者58例,健康人26例。将高脂血症患者随机分为治疗组(n=28,辛伐他汀20mg/d,8周)和对照组(n=25),并以健康人作为正常组(n=26)。所有入选者检测颈动脉内中膜校正IBS(corrected IBS,C-IBS),颈动脉内中膜厚度(intima-mediathickness,IMT)和血清MMP-9。结果:高脂血症患者治疗组及对照组颈动脉内中膜C-IBS显著低于正常组(均P<0.05);而颈动脉IMT和血清MMP-9均显著高于正常组(均P<0.05)。直线相关分析显示,高脂血症患者颈动脉内中膜C-IBS与血清MMP-9呈负相关(r=-0.76,P<0.05)。辛伐他汀治疗8周后血清MMP-9较治疗前显著降低(P<0.05)。结论:高脂血症患者颈动脉内中膜C-IBS降低、血清MMP-9增高,且两者显著相关,可能两者均反映早期颈动脉粥样硬化;辛伐他汀降低血清MMP-9可能是其抗动脉粥样硬化的机制之一。

the simvastatin treatment group and the control group was significantly lower than that in the normal control group （ all P 〈 0.05 ）. The IMT and MMP-9 in the simvastatin treatment group and the control group were significantly higher than those in the normal control group （ all P 〈 0.05 ）. There was a negative correlation between the C-IBS of carotid arteries and the serum MMP-9 levels in the patients with hyperlipemia （ r = - 0.76, P 〈 0.05 ）. Eight weeks after the simvastatin treatment, the serum MMP-9 levels decreased significantly （ P 〈 0.05 ）. Conclusion There is a negative correlation between the decreased C-IBS of carotid arteries and the increased serum MMP-9 levels in patients with hyperlipemia. The decreased C-IBS of carotid arteries and the increased serum MMP-9 levels may be the early indicators of atherosclerosis in hyperlipemia patients. The anti-atherosclerosis effect of simvastatin may partly attribute to its ability to lower the serum MMP-9.