阿托伐他汀对急性冠脉综合征患者血清CD40L和MMP-9水平的影响

目的：观察阿托伐他汀对急性冠脉综合征（acute coronary syndrome,ACS）患者血清白细胞分化抗原配体40（CD40L）和基质金属蛋白酶-9（MMP-9）水平的影响。方法：将67例ACS患者随机分为他汀治疗组35例（阿托伐他汀20mg/d）和非他汀治疗组32例。分别于发病24h内和治疗7d后测定血清CD40L和MMP-9水平;选取同期健康查体者35例为对照组。结果：治疗前ACS患者血清CD40L和MMP-9水平均较对照组高（P〈0.01）;ACS患者治疗7d后CD40L和MMP-9水平均较治疗前降低,且他汀治疗组两者降低程度明显高于非他汀治疗组,差异均有统计学意义（P〈0.05）;ACS患者血浆CD40L和MMP-9之间成正相关（r=0.52,P〈0.001）。结论：ACS患者血清CD40L和MMP-9水平增高,血清CD40L与MMP-9之间成正相关;阿托伐他汀可以降低ACS患者血清CD40L和MMP-9表达,减少冠状动脉粥样斑块炎症反应和基质成分降解,具有稳定斑块作用;ACS患者早期应用他汀类强化治疗可能对患者的治疗效果更好,对进一步预防ACS患者的心脏缺血事件有积极作用。

The Impact of Atorvastatin on Serum CD40L and MMP-9 Levels of Patients with Acute Coronary Syndrome

Objective：To observe impact of atorvastatin on leukocyte differentiation antigen ligand 40（CD40L） and matrix metalloproteinase-9（MMP-9） levels of patients with acute coronary syndrome.Methods：67 patients with ACS were randomly divided into statin treatment group（35 cases,atorvastatin,20 mg/d） and non-statin treatment group（32 cases）.Serum CD40L and MMP-9 levels were measured within 48 hours after onset and in 7 days after treatment,respectively.Control group were 35 healthy people over the same period.Results：Before treatment,serum CD40L and MMP-9 levels of patients with ACS were higher than those of control group（P〈0.01）. 7 days after treatment,CD40L and MMP-9 levels of ACS patients decreased,and statin treatment group reduced significantly higher than non-statin treatment group,the differences were statistically significant （p0.05）.CD40L and MMP-9 were positive correlation in ACS patients （r=0.52,P〈0.001）.Conclusion：Levels of CD40L and MMP-9 in ACS patients increase, CD40L and MMP-9 are positive correlation.Atorvastatin can reduce the expression of serum CD40L and MMP-9 in patients with ACS,and reduced coronary plaque inflammation and matrix component degradation,it can stable plaque.Early statin therapy may enhance outcomes and have a positive effect on prevention of further cardiac ischemic events of ACS patients.