辛伐他汀对不同血脂水平急性冠状动脉综合征患者血清基质金属蛋白酶水平的影响

目的　研究正常血脂和高血脂急性冠状动脉综合征 (ACS)患者应用辛伐他汀对抑制动脉粥样硬化斑块细胞外基质降解 ,减少炎症反应 ,稳定斑块的作用。方法　采用双盲、随机、对照方法 ,将正常血脂 (NC组 )和高血脂 (HC组 )ACS患者分为他汀治疗组 (辛伐他汀 2 0mg d ,共 8周。NC组 ,n =33;HC组 ,n =36 )和他汀对照组 (NC组 ,n =32 ,HC组 ,n =36 ) ;于治疗前后分别测定血清基质金属蛋白酶 (MMP) 1、MMP 9、基质金属蛋白酶抑制因子 (TIMP) 1、MMP 9 TIMP 1、高敏C 反应蛋白(hs CRP)水平。结果　 (1)治疗前NC、HC各组的血清MMP 1、MMP 9、MMP 9 TIMP 1、TIMP 1、hs CRP水平均较健康对照组 (n =6 0 )明显增高 ,与血脂水平不相关。 (2 )经辛伐他汀治疗 8周后 ,两治疗组血清MMP 1、MMP 9、MMP 9 TIMP 1、hs CRP水平均明显降低 ,血清TIMP 1水平无显著性差异。HC他汀治疗组血清总胆固醇 (TC)、甘油三酯 (TG)、低密度脂蛋白胆固醇 (LDL C)水平明显降低 ,高密度脂蛋白质胆固醇 (HDL C)水平略有上升 ;NC他汀治疗组血清TC、LDL C水平明显下降 ,TG、HDL C水平略有上升和下降 ,但无显著差异。结论　在正常血脂和高血脂ACS患者中 ,早期应用他汀治疗 ,可减少斑块基质成分的降解和炎症反应 ,具有稳定斑块作用。

Effect of simvastatin on serum matrix metalloproteinases-1, matrix metalloproteinases-9,tissue inhibitor of metalloproteinases-1,high sensitive C-reactive protein levels in patients of acute coronary syndrome in serum normocholesterolemia and hypercholest

Objective To observe the influence of simvastatin on serum matrix metalloproteinases-1(MMP-1), MMP-9, tissue inhibitor of metalloproteinases-1(TIMP-1), MMP-9/TIMP-1, and high sensitive C-reactive protein (hs-CRP) levels in patients of acute coronary syndrome (ACS) with serum normocholestemia level (NC group) and hypercholesterolemia level (HC group ). Methods Sixty-two NC and Sixty-nine HC patients of ACS were stratified by randomized, double-blind, contrastive assigned to simvastatin group (20 mg/d of simvastatin for 8 weeks. NC group, n=33. HC group, n=36) or to the control group ( no lipid-lowering drugs. NC group, n=32. HC group, n=36). The serum levels of MMP-1, MMP-9, TIMP-1, MMP-9/TIMP-1, hs-CRP before and after treatment were detected. Results (1) The patients with ACS both NC group and HC group had higher levels of serum MMP-1,MMP-9,TIMP-1, MMP-9/TIMP-1 and hs-CRP compared with those of healthy group (P<0.001, P<0.05, P<0.01. n=60) and had no correlation to levels of serum lipids. (2)After treatment of simvastatin, the levels of serum MMP-1, MMP-9, MMP-9/TIMP-1, and hs-CRP in both two groups of simvastatin treatment significantly decreased (P<0.001, P<0.01), serum TIMP-1 had no change. The levels of serum TC, TG, LDL-C in HC group of simvastatin treatment significantly reduced (P<0.001) and those of serum TC, LDL-C reduced (P<0.01,P<0.05), TG, HDL-C had no change (P>0.05) in NC group of simvastatin treatment. Conclusion Simvastatin decreased breakdown of matrix collagen, and inflammatory reaction in the patients of both NC and HC levels of ACS which may have effect on plaque stabilization.