不同剂量瑞舒伐他汀早期治疗对急性冠脉综合征PCI术后单核细胞MMP-9表达的影响

Influence of early administration rasuvastatain on the expressions of MMP-9 in circulating monocytes after percutaneous coronary intervention in patients with acute coronary syndrome

目的探讨瑞舒伐他汀早期治疗对急性冠脉综合征(ACS)经皮冠状动脉介入治疗(PCI)术后外周血单核细胞基质金属蛋白酶-9(MMP-9)表达的影响。方法 40例确诊非ST段抬高ACS拟行PCI术住院患者为实验组(ACS组),术前随机接受瑞舒伐他汀10 mg(10 mg组,n=20)和20 mg治疗(20 mg组,n=20),同时选取因各种临床需要行冠状动脉造影术(CAG)检查的正常者为对照组(n=20)。分别于术前、术后24 h及术后7 d抽取肘静脉血,采用ELISA法测定MMP-9蛋白的浓度,并测定血脂水平;采用UNIQ-10柱式TRIzon总RNA试剂盒提取总RNA,扩增目的基因MMP-9mRNA。结果与对照组比较,ACS组单核细胞MMP-9 mR-NA及蛋白表达明显增加(P<0.05);ACS组PCI术后单核细胞MMP-9 mRNA及蛋白表达水平较术前逐渐下降(P<0.05);与瑞舒伐他汀10 mg组比较,20 mg组PCI术后单核细胞MMP-9 mRNA及蛋白表达显著降低(P<0.05)。结论ACS组单核细胞MMP-9表达水平较对照组明显增加,可能直接参与了不稳定斑块的形成及破裂;早期瑞舒伐他汀治疗可有效下调ACS单核细胞MMP-9的表达水平,呈剂量依赖性,起到抗炎和稳定斑块的作用。

Objective To evaluation the effects of early administration with different-doses of rosuvastatain on MMP-9 in circulating monocytes after percutaneous coronary intervention（PCI） in patients with no ST-segment elevation acute coronary syndrome（ACS）.Methods The 40 patients with no ST-segment elevation ACS who underwent PCI were randomly divided into two groups： rosuvastatain 10 mg（n=20） and 20 mg（n=20） with routine treatment,and 20 controls without coronary heart disease（CHD） were included in this cross-sectional study.The MMP-9 protein concentration were detected by enzyme-linked immunosorbent assay（ELISA） before PCI and at 24 hours,7 days after PCI,and the lipid levels were detected at the same time.Then the total RNAs were isolated from these cells and the expressions of MMP-9 mRNA were examined by RT-PCR.Results The levels in peripheral blood mononuclear cells in patients with ACS of MMP-9 mRNA and protein expression were significantly increasedcompared with control group（P0.05）.In the ACS patients group,peripheral blood mononuclear cells of MMP-9 mRNA and protein expression levels gradually declined after PCI compared with the preoperation,the gap has a statistically significant（P0.05）.Furthermore,in comparison with rosuvastatin statin 10 mg and 20 mg treatment groups,the level of MMP-9 expression in high dose group after PCI decreased significantly（P0.05）. Conclusion：Peripheral blood mononuclear cells of patients with ACS and MMP-9 expression were markedly increased,which may be directly involved in the formation and rupture of unstable plaque.Rosuvastatin statin intervention can effectively down-regulate the expression of MMP-9 in patients with ACS in a dose-dependent manner,and played the role of anti-inflammation and plaque stabilization.