脑栓通胶囊对脑梗死患者基质金属蛋白酶9及颈动脉粥样硬化斑块的影响

Influence of Naoshuantong Capsule on matrix metalloproteinase-9 and carotid arteries atherosclerotic plaques in patients with acute cerebral infarction

目的探讨脑栓通胶囊对急性颈内动脉系统脑梗死患者血清基质金属蛋白酶9(MMP-9)及颈动脉粥样硬化斑块的影响。方法将132例合并颈动脉易损斑块形成的急性脑梗死患者随机分成两组,常规组给予常规治疗(拜阿司匹林0.1 g,1次/d+立普妥20 mg,1次/d),脑栓通组在常规治疗基础上加用脑栓通口服,3粒/次,3次/d,连服6个月。治疗前后检测血清MMP-9含量,并行颈动脉彩超测定颈动脉内中膜厚度(intima-media thickness,IMT)、动脉粥样硬化斑块积分(Crouse积分)及斑块总面积。结果治疗14 d后两组MMP-9与治疗前相比均有下降,脑栓通组下降更明显,与常规组相比差异有高度统计学意义(P<0.01)。两组在治疗3个月后IMT、斑块积分及斑块总面积均有改善,组间比较差异无统计学意义(P>0.05)。在治疗6个月后脑栓通组疗效更显著,组间比较差异有统计学意义(P<0.05)。结论脑栓通能降低急性期脑梗死患者血清炎症因子(MMP-9)的浓度,并随疗程的延长,能改善颈动脉粥样斑块性状,提高斑块稳定性,降低脑梗死再发风险。

Objective To observe the influence of Naoshuantong Capsule on matrix metalloproteinase-9（MMP-9） and carotid atherosclerotic plaques in patients with acute cerebral infarction in internal carotid arterial system.Methods 132 patients with infarction complicating with vulnerable carotid arteries plaques were divided into two groups： Naoshuantong Capsule group and conventional treatment group,and each group had 66 cases.All patients received oral Aspirin（0.1 g,once per day） and Atorvastatin（20 mg,once per day）,while the Naoshuantong Capsule group received oral Naoshuantong Capsule（three times a day,3 for each time） for extra.Before and after medication,serum MMP-9 levels were measured.Intima-media thickness（IMT）,Crouse scores and areas of plaques were measured by color Doppler ultrasound.Results After 14 days medication,the levels of MMP-9 in both two groups were lower than before.It was significantly lower in Naoshuantong Capsule group than in conventional treatment group（P 0.01）.After treatment for 3 months,thinner IMT,lower Crouse scores and smaller areas of plaques were all improved in both two groups,while there were no significant differences between the two groups（P 0.05）.There were more significantly therapeutic effects in conventional treatment group than in conventional treatment group after 6 months medication（P 0.05）.Conclusion Naoshuantong Capsule can reduce MMP-9 level in patients with acute cerebral infarction.With the treatment prolonging,Naoshuantong Capsule can narrow and stabilize carotid atherosclerotic plaques and prevent the recurrence of acute cerebral infarction.