辛伐他汀与瑞舒伐他汀对心肌梗死患者PCI后血浆NT-proBNP、MMP-2表达及左室重构作用比较

目的:探讨辛伐他汀与瑞舒伐他汀对心肌梗死(AM I)行PC I术后慢性心功能衰竭(CHF)患者血浆氨基末端脑利钠肽前体(NT-proBNP)和基质金属蛋白酶-2(MMP-2)表达以及对左室重构作用的比较。方法:80例AM I行PC I术后CHF患者分别加服辛伐他汀10 mg/d或瑞舒伐他汀10 mg/d,持续12个月;ELISA法和酶谱法检测患者血浆中NT-proBNP和MMP-2水平,彩色多普勒超声观测左心室射血分数(LVEF)、左心室质量指数(LVM I)、左室舒张末期内径(LVEDD)、舒张末期左室后壁厚度(LVPWT)、舒张末期室间隔厚度(IVST)、左室短轴缩短率(FS)、左室平均周径缩短率(MVCF)、二尖瓣口舒张早期最大流速和舒张末期最大流速比率(E/A)。结果:治疗后瑞舒伐他汀组血浆NT-proBNP和MMP-2及LVM I、LVEDD、LVPWT均显著低于辛伐他汀组(P<0.01);而IVST、FS、MVCF、E/A显著高于辛伐他汀组(P<0.01)。结论:瑞舒伐他汀较辛伐他汀能显著降低PC I术后CHF患者血浆NT-proBNP和MMP-2水平,并减轻左室重构。

Comparsion between Simvastatin and Rosuvastatin on Effects of Plasma NT-proBNP,MMP-2 Expression and Left Ventricular Remodeling in Patients with CHF after PCI Therapy

Objective To compare the effects of Simvastatin and Rosuvastatin on plasma N-terminal pro-brain natriuretic peptiede(NT-proBNP),matrix metalloproteinase-2(MMP-2) expression and left ventricular remodeling in patients with chronic heart failure after percutaneous coronary intervention(PCI) therapy for acute myocardial infarction(AMI).Methods Simvastatin or Rosuvastatin were respectively given with dose of 10 mg/d for 12 months in 80 patients with CHF after PCI for AMI.The plasma levels of NT-ProBNP and MMP-2 were detected by ELISA and zymogram method.The left ventricular remodeling parameters were measured by Doppler echocardiography,such as left ventricular ejection fraction(LVEF),left ventricular mass index(LVMI),left ventricular end-diastolic diameter(LVEDD),left ventricular posterior wall thickness(LVPWT),interseptal ventricular septal thickness(IVST),fractional shortening(FS),shortening rate of average(MVCF),mitral valve peak flow velocities during early diastole(E) and atrial systole(A) before and after treatment.Results The NT-ProBNP and MMP-2 levels,LVMI,LVEDD and LVPWT in Rosuvastatin group were obviously lower than that in Simvastatin group(P<0.01),IVST,FS,MVCF and E/A in Rosuvastatin group were obviously higher than that in Simvastatin group(P<0.01).Conclusion Compared with Simvastatin,Rosuvastatin could effectively decrease plasma NT-ProBNP,MMP-2 levels and left ventricular remodeling.