强化降脂治疗对急性冠状动脉综合征患者基质金属蛋白酶的影响  

Effects of large dosage atorvastatin on serum metalloproteinases in patients with acute coronary syndrom

作　　者：喻学刚[1] 王军昌[1] 于娜[1] 麦永东[1] 张宜雅[1] 

机构地区：[1]中医药大学祈福医院心内科,广州511495

出　　处：《心肺血管病杂志》2011年第2期119-121,共3页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:比较40～60 mg阿托伐他汀的强化降脂与20 mg阿托伐他汀治疗相比,对急性冠状动脉综合征(ACS)患者血脂、高敏C反应蛋白(hs-CRP)、基质金属蛋白(MMP)的影响及其安全性。方法:选取ACS患者46例,随机分为较大剂量(40～60 mg)组和常规剂量(20 mg)组,观察服药前、服药后1 w、4 w时血脂:总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、hs-CRP、MMP-2、MMP-9水平的变化。结果:1.强化治疗组1 w时就出现TC、LDL-C水平的下降(P<0.05),4 w时下降更明显(P<0.01),且降脂效果较常规治疗组更显著(P<0.05);2.强化治疗组1 w时hs-CRP、MMP-2及MMP-9水平开始下降,4 w时下降更显著,其效果明显优于常规治疗组;3.强化降脂治疗与常规治疗组相比,肝、肾功能,肌酸激酶(CK)均无明显改变。结论:对于ACS患者,早期的强化降脂治疗能更显著的降低血脂、hs-CRP及MMP水平,能更好的发挥他汀的抗炎及稳定斑块的作用。Objective：To evaluated the effect of different dosage atorvastatin on serom metalloproteinases（MMP）,C-reactive protein（CRP） and lipids in patiente with acute coronary syndrom（ACS） as well as its safty.Methods：46 patients with ACS were randomized to receive atorvastatin（20 mg/d,goup 1） or（40-60 mg/d,group 2） after admition.Serom lipids,CRP and MMP were assessed at baseline,1week and 4 weeks after treatment.Results：1.Compared to baseline,the levels of total cholesterol（TC）,LDL-C were significantly reduced after 1 week（P〈0.05） and 4 weeks（P〈0.01） in group 2.2.MMP-2,MMP-9 and CRP significantly decreased at 1 week（P〈0.05）and 4 weeks（P〈0.01） compared to baseline in two group,But compared to that of group 1,there is more obviously decrease in group 2.3.AST,renal function and creatine kinase remained unchanged after therapy.Conclusion：Large dosage atorvastatin（40-60mg） therapy early is superior to atorvastatin（20mg） in decreasd serom lipids,anti-inflammation and stablised lipide lesion.

关 键 词：急性冠状动脉综合征 降脂药 高敏C-反应蛋白 基质金属蛋白 

分 类 号：R541.4[医药卫生—心血管疾病]