【摘要】 目的探讨瑞舒伐他汀强化治疗对急性心肌梗死(AMI)后未行经皮冠状动脉介入术(PCI)患者血清脂联素(APN)及基质金属蛋白酶(MMP-9)水平的影响。方法将112例AMI后未行PCI术患者随机分为3组:A组给予常规药物治疗,包括阿司匹林、氯比格雷、硝酸盐类、β受体阻滞剂等常规药物治疗;B组在A组基础上加服瑞舒伐他汀10mg/d;C组在A组基础上加服瑞舒伐他汀20mg/d。3组患者在用药前测定血脂中总胆固醇、甘油三酯和低密度脂蛋白胆固醇水平,并分别于用药前和用药后1、16周空腹静脉采血检测APN及MMP-9水平。结果 3组患者用药前血脂水平无显著差异(P>0.05);用药1周后,3组患者血清APN及MMP-9水平较治疗前均有好转,但差异无统计学意义(P>0.05);用药16周后,B、C组的观测指标较治疗前明显改善,且C组改善更为明显,表现为患者血清APN水平明显上升(P<0.05)及MMP-9水平明显下降(P<0.05),A组各项观测指标也有一定改善,但改善程度不显著(P>0.05);用药16周后,C组上述指标改善程度显著优于A、B组(P<0.05)。结论瑞舒伐他汀强化治疗可有效控制炎症反应,抑制动脉粥样硬化并加强斑块稳定性,可有效抑制心室重构,从而改善患者心功能及远期预后。更多还原

【Abstract】 Objective To explore the influence of rosuvastatin intensive therapy on serum concentration of APN and MMP-9 in the acute myocardial infarction(AMI)patients without percutaneous coronary intervention(PCI). Methods 112 AMI patients without PCI were randomly divided into three groups. Conventional treatment group(group A)was treated with conventional drugs such as aspirin, clopiclogrel, nitrate andβ-blocker. Normal-dose rosuvastatin group(group B)was treated with 10 mg/d rosuvastatin in addition on the basis of group A. Large-dose rosuvastatin group(group C)was treated with 20 mg/d rosuvastatin in addition on the basis of group A. The levels of TC, TG and LDLwere detected before treatment,and levelsof APN and MMP-9 were detected at the time points of before treatment, one week and 16 weeks after treatment. Results There were no significant differences of TC, TG and LDL levels before treatment in all the groups(P> 0.0 5).Oneweekaftertreatment,thelevelsofAPNandMMP- 9improvedinthreegroups( P> 0.0 5).1 6 weeksaftertreatment,the levelsofAPNandMMP- 9 ingroupBandgroupCimproved significantly, and the most significant improvement was observed in group C. In group C,thelevelofAPNincreasedsignificantly(P< 0.0 5),MMP- 9 decreasedsignificantly(P<0.05). 16 weeks after treatment, the levels of APN and MMP-9 in group C were significantly better than those in group A and group B(P< 0.05). Conclusion Rosuvastatin intensive therapy can effectively control the inflammatory reaction, delay the proceeding of atherosclerosis, enhance plaque stability, inhibit ventricular remodeling and improve heart function and long-term prognosis.更多还原