莲子心对不稳定心绞痛患者生活质量及基质金属蛋白酶-9和基质金属蛋白酶抑制因子-1mRNA表达水平的影响

Effects of plumula nelumbinis on life quality and the expression of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 mRNA in patients with unstable angina

目的:探讨了莲子心对不稳定心绞痛(UAP)患者的生活质量和基质金属蛋白酶-9(MMP-9)及基质金属蛋白酶抑制因子-1(TIMP-1)基因表达水平的影响;并分析生活质量和MMP-9、TIMP-1 mRNA表达水平之间的相互关系。方法:研究共计纳入健康人30名(正常组),不稳定心绞痛患者120例,其中不稳定心绞痛患者随机分为莲子心治疗组(简称治疗组,60例)和标准治疗组(简称对照组,60例),两组均进行标准化基础治疗,其中治疗组加用莲子心,疗程3周。治疗前后采用西雅图心绞痛量表(SAQ)进行生活质量评价,从躯体活动受限程度(PL)、心绞痛稳定状态(AS)、心绞痛发作情况(AF)、治疗满意程度(TS)、疾病认识程度(DP)进行评分。并检测MMP-9和TIMP-1 mRNA表达水平变化。结果:治疗后,对照组和治疗组SAQ评分均升高(P<0.01),且治疗组AS、AF、TS评分明显高于对照组(P<0.01)。治疗前,对照组和治疗组的MMP-9 mRNA表达水平、MMP-9/TIMP-1比值(M/Tr)均明显高于正常组,而TIMP-1 mRNA表达水平治疗前后均低于正常组(P<0.05,P<0.01)。治疗后,对照组和治疗组MMP-9 mRNA表达水平及M/Tr均明显下降(P<0.05,P<0.01);且治疗组MMP-9 mRNA表达水平及M/Tr明显低于对照组(P<0.05,P<0.01)。生活质量SAQ评分与MMP-9 mRNA表达水平呈负相关、与TIMP-1 mRNA表达水平呈正相关(P<0.05)。结论:UAP患者生活质量SAQ评分与MMP-9mRNA表达水平存在负相关性,与TIMP-1 mRNA表达水平存在正相关性;且莲子心可在标准治疗基础上,降低UAP患者MMP-9 mRNA表达水平及M/Tr,从而改善UAP患者的生活质量。

Objective： To observe the effects of plumula nelumbinis on life quality and the expression of matrix metalloproteinase-9 （MMP-9） and tissue inhibitor of metalloproteinase-1 （TIMP-1） mRNA in patients with unstable angina, and to analyze the correlation between life quality and expression of MMP-9 and TIMP-1 mRNA. Methods： 30 healthy persons were included as normal group, and 120 patients with unstable angina were included and randomly divided into treatment group with plumula nelumbinis （treatment group, 60 cases） and the standard treatment group （control group, 60 cases）. The control group was treated with standardize basic treatment, and the treatment group was treated with plumula nelumbinis based on standardize basic treatment. The treatment course was 3 weeks. The Seattle Angina Questionnaire （SAQ） was used to evaluate the life quality before and after treatment from the physical limitation （PL）, angina stability （AS）, angina frequency （AF）, treatment satisfaction （TS） and disease perception （DP）. The expression of MMP-9 and TIMP-1 mRNA were tested. Results： The SAQ score of the treatment group and the control group both increased （P〈0.01）, and the AS, AF and TS scores of the treatment group were higher than that of the control group （P〈0.01）. The level of MMP-9 mRNA, ratio of MMP-9 and TIMP-1 （M/Tr） were both higher than the normal group, but the level of TIMP- 1 mRNA was lower before and after treatment than the control group （P〈0.05, P〈0.01）. After treatment, the level of MMP-9 mRNA and M/Tr of the treatment and control groups were both decreased, but the level of MMP-9 mRNA and M/Tr of the treatment group were lower than the control group （P〈0.05, P〈0.01）. The SAQ score demonstrated a negative correlation with the level of MMP-9 mRNA, and demonstrated a positively correlated relationship with the level of TIMP-1 mRNA （P〈0.05）. Conclusion： The life quality of patients with unstable angina demonstrated a negative correlation with the level of MMP-9 mRNA, and demonstrated a positively correlated relationship with the level of TIMP-1 mRNA. Plumula nelumbinis could improve the quality of life of patients with UAP by reducing the level of MMP-9 mRNA and M/Tr and increasing the level of TIMP-1 mRNA on the base of standard basic treatment.