【摘要】 目的探讨基质金属蛋白酶-9(MMP-9)及脂蛋白-a[LP(a)]与高血压合并2型糖尿病(DM)患者颈动脉粥样硬化的关系。方法单纯高血压患者82例采用彩色超声仪进行颈动脉超声检查,检测颈动脉内膜-中膜厚度(IMT),采用ELISA法测定血清中MMP-9及LP(a)等指标;并以同样的方法观察高血压合并2型DM的患者86例辛伐他汀(10mg/d.次)治疗12周前后的上述指标。结果高血压合并2型DM的患者IMT值、斑块发生率、颈动脉斑块积分及MMP-9和LP(a)等值明显高于单纯高血压患者[IMT:(1.29±0.10vs0.96±0.15)mm;斑块发生率:(79.8%vs22.6%);颈动脉斑块积分:(6.0±0.4vs1.7±0.7);MMP-9:(649.1±51.0vs213.2±23.3)μg/L;LP(a):(2132.0±342.2vs765.4±154.1)mg/L(P<0.01)]。MMP-9及LP(a)与高血压合并2型DM的患者IMT值、颈动脉斑块发生率、斑块积分呈正相关,r值分别为(0.80、0.74、0.84、0.76、0.78、0.80,P<0.05)。经辛伐他汀治疗12周,MMP-9和LP(a)下降,颈动脉斑块有所消退。结论MMP-9及LP(a)在高血压合并2型糖尿病患者颈动脉粥样硬化发生发展过程中可能起重要作用。经辛伐他汀治疗,在MMP-9及LP(a)下降的同时颈动脉斑块有所消退。更多还原

【Abstract】 Objective To observe the relationship between carotid atherosclerosis and matrix metalloproteinase-9(MMP-9) and Lipoprotein(a)[LP(a)] in hypertensive patients complicated with 2 type diabetes mellitus(EH+DM). Methods The carotid artery intima-media thickness (IMT) and carotid plaques were measured by ultrasonography and the serum MMP-9 and LP(a) were determined by ELISA in 82 hypertensive patients alone(EH) and in 86 EH+DM before and after simvastatin treatment. Results IMT, carotid plaques score and incidences of carotid atherosclerosis plaques were greater in patients with EH+DM, compared with patients of EH alone (P all <0.01). Serum MMP-9 and LP(a) were higher than that in EH. Serum MMP-9 was positively related with IMT, carotid atherosclerosis score (r=0.84, 0.80, P<0.01). After simvastatin treatment for 12 weeks, the levels of serum MMP-9, TC, LDL-C, Ox-LDL were reduced and IMT, carotid plaques were ameliorated. Conclusion MMP-9 combined with LP(a) may play a role in the development and progression of carotid atherosclerosis in hypertensive patients complicated with diabetes mellitus. Simvastatin treatment decreased IMT and carotid atherosclerosis plaques in associated with the decreases in MMP-9 and LP(a).更多还原