不同剂量阿托伐他汀对经皮冠状动脉介入治疗术后基质金属蛋白酶-9和高敏C反应蛋白的影响

Effects of different doses of atorvastatin on expression of MMP-9 and hs-CRP levels in patients with AMI after PCI

目的 探讨不同剂量阿托伐他汀对直接经皮冠状动脉介入治疗术（PCI）后基质金属蛋白酶-9 （MMP-9）和高敏C反应蛋白（hs-CRP）的影响.方法 96例接受直接PCI的急性心肌梗死（AMI）患者随机分为大剂量组和标准剂量组,两组各48例,于术前分别给予阿托伐他汀钙片40 mg和20 mg口服,术后两组分别继续每日睡前口服40 mg和20 mg持续1周,1周后均同为20 mg睡前口服.于术前及术后24小时、72小时、1周和1个月测定血清MMP-9、hs-CRP水平.结果 两组hs-CRP、MMP-9水平PCI术后24小时均升高（P＜0.01）,术后72小时逐渐下降,术后l周低于术前（P ＜0.01）;40 mg剂量组下降更显著.结论 AMI患者PCI术后使用大剂量阿托伐他汀不良反应无明显增加,可明显降低hs-CRP、MMP-9水平,减少炎症反应,保护血管内皮功能,预防支架内血栓形成.

Objective To investigate the effects of different doses atorvastatin on the expression of matrix metalloproteinases（MMP-9） and high sensitive C-reactive protein（hs-CRP） in patients with acute myocardial infarction（AMI） after percutaneous transluminal coronary intervention（PCI）.Methods 96 patients with AMI underwent PCI were randomly divided into the high-dose group（n =48） and standard treatment group（n =48）,respectively gave 40 mg or 20 mg of atorvastatin calcium tablet in the preoperative oral,postoperative respectively continued after taking a week to 20 mg.The serum levels of MMP-9 and hs-CRP were determined in the preoperative and postoperative 24 h,72 h,one week and one month.Double layer resistance ABC-ELISA were performed for measurement of MMP-9 and the concentration of hs-CRP was measured by immune turbidimetry.Results The levels of serm MMP-9 and hs-CRP in two groups were increased at 24 h（P 〈0.01）,declined gradually at 72 h and decreased significantly at one week post-PCI（P 〈 0.01）,especially in treatment group.Conclusion High dose atorvastatin significantly reduced the levels of MMP-9 and hs-CRP,protected the vascular endothelial function,prevented stent thrombosis.