基质金属蛋白酶-3、C反应蛋白与颈动脉硬化的相关性研究

目的研究颈动脉粥样硬化患者血清基质金属蛋白酶-3(MMP-3)、高敏C反应蛋白(hsCRP)的变化,探讨两者之间的关系,阿托伐他丁的干预作用。方法对77例来院就诊病人行颈动脉超声检查,根据颈动脉内中膜厚度(IMT)、有无动脉斑块及斑块的性质,分为三组:颈动脉软斑组(N=36),颈动脉硬斑组(N=18),对照组(N=23);检测血清MMP-3及hsCRP水平,分析MMP-3及hsCRP的水平与颈动脉硬化、斑块性质的关系,并对其中18例颈动脉软斑患者用阿托伐他丁治疗12周,观察斑块及MMP-3及hsCRP的水平的变化。结果(1)MMP-3水平:颈动脉软斑组、颈动脉硬斑组、对照组分别为8.27±5.12ng/ml、6.15±2.20ng/ml、3.87±2.31ng/ml,三组间差异有统计学意义;CRP水平则分别为4.82±2.02mg/L、1.54±1.01mg/L、1.45±1.01mg/L,颈动脉软斑组高于颈动脉硬斑组及对照组(P<0.001),颈动脉硬斑组与对照组之间差异无统计学意义(P>0.05);(2)颈动脉软斑病人阿托伐丁治疗12周后血MMP-3的水平明显下降,复查颈动脉彩超,斑块明显好转,hsCRP的水平变化不明显(P>0.05)。结论血清MMP-3水平与颈动脉硬化及斑块性质有密切关系,阿托伐他丁有改善颈动脉硬化,降低血清MMP-3水平作用。

A Relative Study Between Matrix Metalloproteinase-3,C-Reactive Protein and Carotid Atherosclerosis

Objective To investigate the relationship between matrix metaUoproteinase-3（MMP-3）, hypersensifive C-reactive protein （hsCRP） and carotid atherosclerosis, And to observe the effects of atorvastafin on carotid atheroselerosis, Methods 77 patients were given carotid supersonic examination, Then they were divided into 3 groups, according to their intimae-media thickness （IMT）, whether there were artery plaques and the character of the plaques, Among them 36 patients were found with soft carotid plaques, and 18 cases with hard carotid plaques, and 23 cases without carotid atherosclerosis. MMP-3 and hsCRP were measured and the relation between the two parameters of MMP-3 and hsCRP, carotid atherosclerosis and the character of the plaques were analyzed. 18 patients with soft carotid plaques received oral atorvastatin 10mg/d for 12 weeks. Then their plaques were observed and their MMP-3 and hsCRP were measured once more. Results 1） MMP-3 in the group with soft plaques （8.27 ±5.12 ng/ml） was significantly higher than the group with hard plaques （6.15 ± 2.20 ng/ml） and without plaques （3.87 ± 2.31 ng/mL）. CRP in the group with soft plaques （4.82± 2.02 mg/l）, was also significantly higher than that in the other two groups （1.54 ± 1.01 mg/l and 1 .45 ＋ 1.01mg/ l, respectively, P 〈 0.001）. There was no significantly difference of CRP in the group with hard plaques and without plaques （ P 〉 0.05） .2） There was an obvious decrease in MMP-3 in patients who had soft carotid plaques and treated with atorvastatin for 12 weeks （ P 〈 0.05）. The patients with soft plaques were reexamined by color Doppler ultrasound, which showed their soft plaques were turning for the better. However, the change in hsCRP was not so evident （P 〉 0.05）. Conclusions High serum level of MMP-3 is closely related to carotid atherosclerosis and the character of plaques, Atorvastatin has effects on improving carotid atherosclerosis and reducing the serum MMP-3 level.