普罗布考联合阿托伐他汀对脑梗死患者血清ox-LDL、MMP-2、MMP-9水平的影响  

The effect of Probucol combinding with Atorvastatin on ox-LDL,MMP-2 and MMP-9 level in serum of stroke patients

作　　者：赵晓晖[1] 周媛[1] 陈娟[1] 陈翠荣[1] 白青科[1] 沈健[1] 夏卫英[1] 陆练军[1] 王连文[1] 

机构地区：[1]上海市浦东新区人民医院神经内科,201200

出　　处：《卒中与神经疾病》2012年第4期202-206,共5页Stroke and Nervous Diseases

基　　金：上海市卫生局科研课题计划资助(编号为2007124)

摘　　要：目的探讨普罗布考联合阿托伐他汀治疗对脑梗死患者血清ox-LDL、MMP-2、MMP-9水平的影响。方法急性脑梗死患者120例,入院查颈动脉彩超提示存在AS斑块,男68例,女52例,平均年龄(74±15)岁(39～84岁),并随机分为两组,第一组男35例,女25例,平均年龄(73±16)岁(39～83岁),予阿托伐他汀(20 mg/d);第二组男33例,女27例,平均年龄(76±18)岁(41～84岁),予阿托伐他汀(20 mg/d)、普罗布考(500 mg/d)联合治疗;两组患者分别于治疗前、治疗后6、12、24月检测血清氧化低密度脂蛋白(ox-LDL)、基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶-2(MMP-2)水平。结果 (1)两组治疗前ox-LDL水平分别为(781.42±32.56)、(777.38±208.91)ng/ml,无显著差异;治疗后6月第一组ox-LDL水平无明显变化(790.24±229.33)ng/ml,而第二组有较明显的下降(626.4±189.78)ng/ml(P<0.05);12月时第一组ox-LDL水平稍有下降(760.89±200.37)ng/ml,但无明显差异(P>0.05),第二组ox-LDL水平进一步明显下降(601.82±181.64)ng/ml(P<0.01);24月时两组继续保持12月时水平(762.53±212.11)、(612.43±193.49)ng/ml。(2)两组治疗前MMP-2水平分别为(186.62±61.74)、(194.78±63.22)ng/ml,MMP-9水平分别为(309.57±112.26)、(324.98±109.45)ng/ml,均无显著差异;治疗后6月均明显下降,即MMP-2分别为(127.94±38.12)、(128.67±40.09)ng/ml,MMP-9分别为(238.34±73.59)、(209.67±68.45)ng/ml,且第二组MMP-9水平下降尤甚(P<0.01);12月时较6月时有轻度上下波动,即MMP-2水平分别为(131.73±37.69)、(116.32±29.85)ng/ml,MMP-9水平分别为(208.93±64.33)、(218.58±70.22)ng/ml;24月时较12月时有所下降,即MMP-2水平分别为(110.88±30.53)、(87.68±25.76)ng/ml,MMP-9水平分别为(201.75±80.07)、(172.93±58.23)ng/ml,且第二组较第一组下降更显著(P<0.01)。结论稳定斑块是治疗脑梗死动脉粥样硬化的重要而长远的策略,普罗布考联合阿托伐他汀可分别从降低低密度脂蛋白(LDL)、抑制ox-LDL的形成,降低血液循环中Objective To explore the effect of Probucol combinding with Atorvastatin on ox-LDL, MMP-2 and MMP-9 in serum of stroke patients. Methods 120 acute cerebral infarction patients, who have ath- erosclerotic plaques examined by carotid artery color Doppler ultrasound at the time of admission, including 68 males and 52 females and the average age were 74 15 yeares （39-84 years）. They were divided into 2 groups randomly. Group 1 containing 35 males and 25 females whose average age were （73 ± 16） yeares （39-83 years） was received Atorvastatin（20 mg/L）; Group 2 containing 33 males and 27 females whose agerage age were （76 ± 18） yeares （41 -84 yeares） was received Atorvastatin（20 mg/L） combinding with Probucol （50（7 mg/L）. The concentration of serum oxidatively modified lowdensity lipoprotein（ox-LDL）, matrix metallo pro- teinases-9 （MMP-9） and matrix metallo proteinases-2 （MMP-2） were detected respectively before treatment, 6months after treatment, 12 months after treatment and 24 months after treatment. The results were compared among groups. Results （1）Changes of ox-LDL level before and after treatment.- the ox-LDL concentration in Group 1 and Group 2 were （781.42 ± 32. 56） ng/ml and （777. 38 ± 208. 91） ng/ml and had no statistical differ- ence; There were no remarkly changes of ox-LDL 6 months after treatment in Group 1 （790. 24 ± 229. 33）ng/ ml while there were apparently decrease in Group 2 （626. 4 ± 189. 78）ng/ml （P〈0. 05）. 12 months after treat- ment the ox-LDL level in Group 1 decreased a bit （760. 89 ± 200. 37）ng/ml with no difference （P〉0. 05） ,and the ox-LDL level in Group 2 decreased continuously to （601.82 ± 181.64） ng/ml （P〈0. 01） ; 24 months after treatment the ox-LDL level in two groups keep the same as those in 12 months after treatment （762. 53 ± 212. 11 ） ng/ml and （612. 43 ± 193. 49 ） ng/ml. （2） Changes of concentration of MMP-2 and MMP-9 ： the MMP-2 level were （186. 62 ± 61.74） ng/m

关 键 词：脑梗死 普罗布考 阿托伐他汀 颈动脉粥样斑块 血清氧化低密度脂蛋白 基质金属蛋白酶-9 基质金属蛋白酶-2 

分 类 号：R743[医药卫生—神经病学与精神病学]