瑞舒伐他汀对颈动脉粥样硬化患者转化生长因子_β1和斑块稳定性的影响  

Effects of rosuvastatin on transforming growth factor β 1 and plaque stability in patients with carotid atherosclerosis

作　　者：苏建 孟凡超[1] 杨霄鹏[2] SU Jian;MENG Fanchao;YANG Xiaopeng(Department of Neurology,Zhengzhou Second People's Hospital,Zhengzhou 450000,China;Department of Neurology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)

机构地区：[1]郑州市第二人民医院神经内科,河南郑州450000 [2]郑州大学第二附属医院神经内科,河南郑州450014

出　　处：《中国实用神经疾病杂志》2018年第23期2566-2572,共7页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨瑞舒伐他汀对颈动脉粥样硬化(CAS)患者转化生长因子1(TGF-β1)和斑块稳定性的影响。方法观察对象为体检发现的CAS患者,年龄50～70岁。CAS诊断方法是应用彩色超声多普勒进行检查双侧颈动脉内膜中层厚度(intima-media thickness,IMT)值,IMT>1.1mm即为CAS。对于颈动脉粥样硬化斑块(CASP)数量和稳定性进行记录。抽取空腹静脉血进行高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、氧化型低密度脂蛋白(ox-LDL)、甘油三酯(TG)、基质金属蛋白酶9(MMP-9)、超敏C反应蛋白(hsCRP)和TGF-β1检测。随机分为2组,A组控制血压、血糖等常规治疗,B组在常规治疗基础上加用瑞舒伐他汀5mg/d口服。观察期12个月。观察2组患者治疗前、治疗12个月的HDL-C、LDL-C、ox-LDL、TG、MMP-9、hsCRP、TGF-β1、颈动脉IMT和CASP的稳定性变化,TGF-β1和MMP-9、hsCRP的相关性。结果 2组治疗前后各项观察指标无明显差别,治疗12个月后A组hs-CRP下降,TGF-β1升高,其他指标无明显改善;B组颈动脉IMT和斑块稳定性比例无明显改变,其他指标均有明显改善;B组改善情况优于A组。结论 CAS患者TGF-β1水平降低,且与CASP的不稳定性有关;瑞舒伐他汀能够通过提高TGF-β1水平改善炎症反应,从而稳定CASP。Objective To explore effects of rosuvastatin on TGF-β1 and plaque stability in patients with CAS.Methods CAS patients,who were found by physical examination,with 50 70 years old,were observed in the study.CAS was dignognosed with bilateral carotid intima media thickness(IMT)>1.1 mm witch examined by color Doppler ultrasound.The number and stability of carotid atherosclerotic plaques(CASP)were recorded.High density lipoprotein cholesterol(HDL C),low density lipoprotein cholesterol(LDL-C),oxidized low density lipoprotein(ox-LDL),glycerin trilaurate(TG),matrix metalloproteinases 9(MMP 9),high sensitivity C reactive protein(hsCRP)and TGF-β1 were inspected in all patients.The patients were randomly divided into 2 groups:group A were given common treatment,group B were given common treatment and rosuvastatin 5 mg/d.They were followed up in 12 months with the indexes:HDL C,LDL C,ox-LDL,TG,MMP 9,hsCRP,TGF-β1,carotid IMT and stability of CASP before and after treatment 12 months;Correlation of TGF-β1,MMP 9 and hsCRP.Results There were no statistical differences of the observed indexes before treatment in the two groups.TGF-β1 and hsCRP but not others indexes were improved in the 12 months after treatment than before treatment in group A.All indexes but carotid IMT and stability of CASP were improved in the 12 months after treatment than before treatment in group B,and they were improved tnan group A.Conclusion The level of TGF-β1 was found lowed in CAS patients,and it correlated with instability of CASP.Rosuvastatin could modify inflammatory reaction by increasing the level of TGF-β1.In this way,it could stabilize CASP.

关 键 词：颈动脉粥样硬化 内膜中层厚度 颈动脉粥样硬化斑块 转化生长因子β1 基质金属蛋白酶9 瑞舒伐他汀 

分 类 号：R543.4[医药卫生—心血管疾病]