瑞舒伐他汀对老年心肌梗死患者心室重构及血清基质金属蛋白酶和TNF-α表达的影响分析

The impact of rosuvastatin on left ventricular remodeling,matrix metalloproteinases and TNF-α in elderly patients with myocardial infarction

目的观察瑞舒伐他汀对老年心肌梗死患者心室重构及基质金属蛋白酶(MMP)-9、MMP-10、白介素(IL)-6及血清肿瘤坏死因子(TNF)-α表达的影响。方法选取该院2013年11月至2015年8月收治的老年心肌梗死患者共92例进行研究,按照随机数表法分为观察组和对照组,每组各46例。观察组应用瑞舒伐他汀进行治疗,对照组则给予氟伐他汀治疗。观察并对比两组患者治疗前后血清IL-6、TNF-α水平的变化、血流动力学参数、心室质量及指数检测结果以及心脏彩超结果。结果治疗后,观察组患者的IL-6、TNF-α水平分别为(47.92±10.25)pg/mL和(109.25±21.33)pg/mL,低于对照组患者(57.11±15.34)pg/mL和(128.16±120.35)pg/mL,差异有统计学意义(P<0.05)。两组患者左心室舒张末期压力(LVEDP)较治疗前降低,左心室收缩压(LVSP)、左室内压上升段最大变化速率(+Dp/dtmax)和左室内压下降最大变化速率(-Dp/dtmax)较治疗前明显升高,两组比较差异有统计学意义(P<0.05)。观察组患者的左心室质量和左心室质量指数(LVMI)下降水平较对照组更为明显,差异有统计学意义(P<0.05)。两组患者的左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、室间隔厚度(IVS)较治疗前均明显降低,左心室射血分数(LVEF)则明显升高,且观察组患者的升高和降低的水平较对照组患者更为明显,两组比较差异有统计学意义(P<0.05)。两组患者的MMP-9和MMP-10表达水平较治疗前均显著降低,同时观察组患者MMP-9和MMP-10的表达水平低于对照组患者,差异有统计学意义(P<0.05)。结论瑞舒伐他汀不仅能有效抑制MMP-9和MMP-10,从而有效逆转心室重构;同时也能有效降低血清IL-6及血清TNF-α表达,提高患者疗效。

Objective To explore the impact of rosuvastatin on left ventricular remodeling ,MMP-9 ,MMP-10 and IL-6 ,TNF-α in elderly patients with myocardial infarction （MI） .Methods A total of 92 elderly patients with MI from November 2013 to August 2015 in the hospital were selected ,and the patients were randomly divided into observation group and control group ,each group had 46 cases .Observation group were treated with rosuvastatin and control group were treated with fluvastatin .Serum IL-6 ,TNF-α ,he-modynamic parameters ,ventricular mass index test results and echocardiography were observed and compared between two groups . Results After treatment ,IL-6 and TNF-α levels of observation group were （47 .92 ± 10 .25） pg/mL and （109 .25 ± 21 .33） pg/mL , which were significantly lower than that of the control group （57 .11 ± 15 .34）pg/mL and （128 .16 ± 120 .35）pg/mL （P 〈 0 .05） . LVEDP of two groups after treatment were decreased ,while LVSP ,＋ Dp/dtmax and -Dp/dtmax after treatment were higher than before treatment ,and the differences of these indicators between the two groups were statistically significant （P〈 0 .05） .Ventricu-lar mass and LVMI level of the observation group decreased more obviously than the control group ,the differences between the two groups were statistically significant （P〈 0 .05） .LVEDD ,LVESD and IVS of the two groups after treatment were lower than before treatment ,while LVEF was increased ,and the changed levels of observation group were much obviously than control group ,the differences between the two groups were statistically significant （P 〈 0 .05） .After treatment ,expression levels of MMP-9 and MMP-10 were significantly lower than before treatment ,in addition ,which in the observation group were significantly lower than that of the control group （P〈 0 .05） .Conclusion Rosuvastatin not only can inhibit the expression of MM P-9 and MM P-10 and ef-fectively reverse ventricular remodeling ,but also can reduce levels of serum IL-6 and TNF-α and improve the efficacy in patients .