氟伐他汀对急性冠状动脉综合征患者基质金属蛋白酶-9及组织因子的影响

目的 观察急性冠状动脉综合征(ACS)患者血清基质金属蛋白酶-9(MMP-9)、血浆组织因子(TF)及血脂的水平;探讨氟伐他汀对ACS患者血清MMP-9、血浆TF及血脂水平的影响,进一步了解氟伐他汀稳定斑块抑制血栓形成的作用.方法 选取ACS患者40例,其中不稳定型心绞痛(UAP)20例,心肌梗死(AMI)20例;稳定型心绞痛(SAP)20例;正常对照13例(对照组).测定入院时血清MMP-9、血浆TF及血脂的水平.再将40例ACS患者随机分成氟伐他汀治疗组20例和常规治疗组20例,2周后再次测定用药后上述指标.血清MMP-9、血浆TF用酶联免疫吸附法测定.结果 ACS患者(AMI组和UAP组)血清MMP-9及血浆TF水平明显高于SAP组和正常对照组,差异有统计学意义(P<0.001,P<0.05);AMI组与UAP组比较血清MMP-9及血浆TF水平明显升高(P<0.05).氟伐他汀组治疗后血清MMP-9及血浆TF、胆固醇、低密度脂蛋白均明显降低.与治疗前比较差异均有统计学意义(均P<0.05);对照组治疗前后各项指标差异均无统计学意义(均P>0.05);氟伐他汀治疗组MMP-9、TF的变化与血脂均无相关性(均P>0.05).结论 ACS患者血清MMP-9及血浆TF水平明显升高,氟伐他汀治疗ACS患者2周可使血清MMP-9及血浆TF水平明显降低,可能有利于稳定动脉粥样斑块和抑制血栓的形成,且这种作用与调脂作用无关.

Effect of fluvastatin on levels of matrix metalloproteinases-9 and tissue factor in patients with acute coronary syndrome

Objective To observe the levels of matrix metalloproteinases-9 (MMP-9) and tissue factor (TF) as well as blood lipid in patients with acute coronary syndrome (ACS) ,and to study the effect of Fluvastatin on levels of serum MMP- 9 and plasma TF. Methods 40 patients with ACS were selected (including 20 patients with AMI and 20 patients with UAP) ,20 stable angina patients (SAP) and 13 patients without coronary heart dis-ease as control group. 40 patients with ACS were randomly assigned to the Fluvastatin group (n = 20) and the rou-tine group (n = 20) in this study. The MMP - 9 and TF were detected on admission and after 2 weeks treatment. Re-suits The levels of MMP-9 and TF were significantly higher in ACS group than that of SAP and control group (P < 0.001 ,P < 0.05) ,which were elevated in AMI group compared with that of UAP group (P < 0.05). The levels of cholesterol (TC) ,low density Lipoprotein (LDL - C) ,MMP- 9,TF decreased significantly at two weeks after treat-ment in fluvastatin group (P < 0.05), but no significant changes were observed in the routine group (P > 0.05). The change of MMP 9, TF and blood lipid was not related in fluvastatin group (P > 0.05). Conclusion Serum MMP-9 and plasma TF in ACS patients are significantly elevated and fluvastatin decreases the levels of MMP-9 and TF after two weeks treatment,so it may be benefit to atheroaclerotic plaque stabilization and prohihit thrombosis for-marion, and this is not related to regulation of blood lipid.