高脂血症患者颈动脉内中膜IBS值和血清MMP-9及辛伐他汀的干预研究

目的:探讨高脂血症患者颈动脉内中膜背向散射积分(integrated backscatter,IBS)的改变及其与血清基质金属蛋白酶-9(matrix metalloprotease-9,MMP-9)的关系,并观察短期辛伐他汀治疗对颈动脉内中膜IBS值及血清MMP.9的影响.方法:高脂血症患者58例,健康人26例.将高脂血症患者随机分为治疗组(n=28,辛伐他汀20 mg/d,8周)和对照组(n=25),并以健康人作为正常组(n=26).所有入选者检测颈动脉内中膜校正IBS(corrected IBS,C-IBS),颈动脉内中膜厚度(intima-media thickness,IMT)和血清MMP.9.结果:高脂血症患者治疗组及对照组颈动脉内中膜C-IBS显著低于正常组(均P＜0.05);而颈动脉IMT和血清MMP-9均显著高于正常组(均P＜0.05).直线相关分析显示,高脂血症患者颈动脉内中膜C-IBS与血清MMP-9呈负相关(r=-0.76,P＜0.05).辛伐他汀治疗8周后血清MMP-9较治疗前显著降低(P＜0.05).结论:高脂血症患者颈动脉内中膜C-IBS降低、血清MMP-9增高,且两者显著相关,可能两者均反映早期颈动脉粥样硬化;辛伐他汀降低血清MMP-9可能是其抗动脉粥样硬化的机制之一.

Quantitative ultrasonic integrated backscatter of the intima-media complex,serum level of matrix metalloprotease-9 and simvastatin in hyperlipemia patients

OBJECTIVE: To determine the diagnostic value of the integrated backscatter (IBS) technique for carotid artery atherosclerosis (AS), to investigate the correlation between IBS of carotid artery and the serum level of matrix metalloprotease-9(MMP-9), and to explore the effect of simvastatin on the IBS value of the carotid artery and serum MMP-9 level in hyperlipemia patients. METHODS: Fifty-eight patients with hyperlipemia and 26 normal controls were enrolled in this study. Patients with hyperlipemia were randomly divided into 2 groups: a simvastatin treatment group (20 mg/d) and a control group (without simvastatin treatment). Twenty-six healthy people were served as normal control group(n=26).The corrected IBS values(C-IBS) in carotid arteries,the intima-media thickness (IMT), and the serum MMP-9 levels were measured in the normal control group and the patients with hyperlipemia before and 8 weeks after the simvastatin therapy. RESULTS: The C-IBS of the simvastatin treatment group and the control group was significantly lower than that in the normal control group (all P<0.05). The IMT and MMP-9 in the simvastatin treatment group and the control group were significantly higher than those in the normal control group (all P<0.05). There was a negative correlation between the C-IBS of carotid arteries and the serum MMP-9 levels in the patients with hyperlipemia (r=-0.76,P<0.05). Eight weeks after the simvastatin treatment, the serum MMP-9 levels decreased significantly(P<0.05). CONCLUSION: There is a negative correlation between the decreased C-IBS of carotid arteries and the increased serum MMP-9 levels in patients with hyperlipemia.The decreased C-IBS of carotid arteries and the increased serum MMP-9 levels may be the early indicators of atherosclerosis in hyperlipemia patients. The anti-atherosclerosis effect of simvastatin may partly attribute to its ability to lower the serum MMP-9.