针刺对急性颈动脉粥样硬化性脑梗死患者血清MMP-9水平的影响

Effect of Acupuncture on Serum MMP-9 Level in Patients with Acute Carotid Atherosclerotic Cerebral Infarction

目的:探讨MMP-9在针刺防治急性颈动脉粥样硬化性脑梗死中的可能作用机制。方法:将64例符合纳入标准的急性颈动脉粥样硬化性脑梗死伴有高脂血症的患者随机分为治疗组和对照组;治疗组32例,对照组29例(脱落3例),两组均采用常规治疗;治疗组加用针刺治疗,对照组加用阿托伐他汀治疗。检测两组患者不同时间点血脂水平和血清MMP-9的变化。结果:1)两组患者治疗后4周,TC、LDL-C水平显著下降(P<0.05),TG变化不明显;治疗组对TC、LDL-C水平的影响与对照组疗效相当。2)两组患者MMP-9水平在治疗前均有较高表达,具有可比性(P>0.05);治疗后2周,其水平均有所降低,但治疗组较治疗前降低更明显(P<0.05),两组间比较有统计差异(P<0.05);治疗后4周,两组患者血清MMP-9水平较治疗前明显降低(P<0.05),组间比较差异显著(P<0.05)。结论:1)针刺可有效改善颈动脉粥样硬化性脑梗死患者的TC、LDL水平,继而减缓动脉粥样硬化的脂质堆积、促进斑块消退;2)针刺可明显降低患者血清MMP-9水平,减轻对斑块内Ⅳ型胶原的降解、促进斑块稳定,进而发挥其防治脑梗死的作用。

Objective： To investigate the action mechanism of MMP- 9 in the prevention and treatment of acute carotid atherosclerotic cerebral infarction. Methods： 64 patients with acute carotid atherosclerosis cerebral infarction accompanying hyperlipidemia were randomly divided into a treatment group and a control group,with32 cases in the treatment group and 29 cases in the control group（ shedding 3 cases）. Two groups were treated with conventional therapy and the treatment group was additionally with acupuncture,and the control group was additionally with atorvastatin. The level of blood lipid and serum MMP- 9 was detected at different time points in two groups. Results： 1） The level of TC and LDL- C was significantly decreased（ P〈0. 05）,and the change of TG was not obvious after 4 weeks＇ treatment in two groups; the effect of treatment group on the level of LDL- C and TC was similar to that of the control group. 2） The level of serum MMP- 9 in two groups was significantly higher than that before treatment,and the two groups were comparable（ P〈0. 05）; after 2weeks＇ treatment,the level of serum MMP- 9 in two groups was decreased,but the treatment group was significantly lower than that before treatment（ P〈0. 05）,and the difference between two groups was statistically significant（ P〈0. 05）; after 4 weeks＇ treatment,the level of serum MMP- 9 in two groups was significantly lower than that before treatment（ P〈0. 05）,and the difference between two groups was significant（ P〈0. 05）.Conclusion： 1） Acupuncture can effectively improve the level of TC and LDL in patients with carotid atherosclerotic cerebral infarction,and can slow down the accumulation of lipid in atherosclerosis and promote plaque regression; 2） Acupuncture can significantly reduce the level of serum MMP- 9 in patients,and can alleviate the degradation of collagen- IV in plaque,promote plaque stability,and play a role in prevention and treatment of cerebral infarction.