他汀类药物与ACEI联用对急性冠脉综合征患者短期疗效观察及机制研究

Short-Term Outcome of HMGCoA Agents Combined with ACEI in the Treatment of Acute Coronary Syndromes and the Mechanisms

目的:观察他汀类药物与血管紧张素转换酶抑制剂(ACEI)联用对急性冠脉综合征(ACS)患者的短期疗效及可能机制研究。方法:选取ACS患者60例,随机分为他汀治疗组和ACEI+他汀治疗组,在治疗4周后测定上述病例和对照组血清中C反应蛋白(CRP)和基质金属蛋白酶-9(MMP-9)的水平变化,观察两治疗组4周内主要终点事件发生情况,并进行统计学分析。结果:ACS组中血清CRP和MMP-9的水平明显高于对照组;ACEI+他汀治疗组在治疗4周后血清MMP-9的水平明显低于他汀治疗组,主要终点事件也有下降趋势。结论:他汀类药物与ACEI联用与单用他汀类药物比较,可通过更为显著降低MMP-9水平,达到减少冠状动脉粥样斑块基质成分的降解,稳定动脉粥样硬化斑块的作用。

Objective： To explore the short term outcome of HMGCoA agents added with ACEI in the treatment of acute coronary syndromes （ACS） and to explore the mechanism. Methods： Sixty patients with ACS were randomly divided into two groups, one treated with HMGCoA agents and the other treated with HMGCoA agents plus ACEI. After four weeks, the serum levels of CRP and MMP-9 were compared among treatment groups and control group, and the primary end point events were observed and compared between the two treatment groups. Results： Serum lev els of CRP and MMP-9 were significant higher in the ACS group than in the control group. Compared with HMGCoA agents group,the HMGCoA agents ＋ ACEI group had a significantly decrease in serum level of MMP-9, and less tendency of primary end point events after four weeks treatment. Conclusion： HMGCoA agents combined with ACEI could significantly decrease the serum level of MMP-9, so it might have a beneficial effect on steadying the plaque.