上海交通大学学报（医学版）

›› 2009, Vol. 29 ›› Issue (10): 1233-.

• 论著（临床研究） • 上一篇    下一篇

阿托伐他汀对血脂及基质金属蛋白酶的影响

杨 晖1, 梁 伟2, 胡 伟1, 顾 俊1, 张大东1, 陆国平2   

  1. 上海交通大学 医学院 1. 瑞金医院集团闵行区中心医院心内科, 上海 201100；2. 瑞金医院老年病科, 上海 200025
  • 出版日期:2009-10-25 发布日期:2009-10-26
  • 通讯作者: 陆国平, 电子信箱: gplu52@yahoo.com.cn。
  • 作者简介:杨 晖（1970—）, 女, 硕士, 主任护师；电子信箱: yanghui158@gmail.com。

Effects of atorvastatin on levels of serum lipid and metalloproteinases

YANG Hui1, LIANG Wei2, HU Wei1, GU Jun1, ZHANG Da-dong1, LU Guo-ping2   

  1. 1. Department of Cardiology, Ruijin Group Shanghai Minhang District Central Hospital, Shanghai 201100, China；2. Department of Geriatrics, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200025, China
  • Online:2009-10-25 Published:2009-10-26

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摘要：

目的 研究较大剂量阿托伐他汀与小剂量阿托伐他汀联合依折麦布对冠心病患者血脂及血清基质金属蛋白酶(MMP)水平的影响。方法 选取冠状动脉狭窄50%~70%的冠心病患者(未植入支架)42例，随机分为较大剂量阿托伐他汀单药治疗组（20、40 mg）（阿托伐他汀组，n=19）和小剂量阿托伐他汀（5、10 mg）＋依折麦布（10 mg）治疗组（联合治疗组，n=23)，检测并分析12周内的血脂指标、肝肾功能、肌酸激酶及血清MMP-2、MMP-9和MMP组织抑制因子-1(TIMP-1)水平的变化。结果 ①12周时阿托伐他汀组的低密度脂蛋白胆固醇（LDL-C）为（1.94±0.49） mmol/L，较治疗前下降37.82％；联合治疗组的LDL-C为（1.92±0.54） mmol/L,较治疗前下降38.26％；两组间治疗前及治疗12周时LDL-C比较差异无统计学意义（P>0.05）。②阿托伐他汀组血清MMP-2和MMP-9水平在12周时均较治疗前明显降低，TIMP-1则明显升高。结论 单用较大剂量阿托伐他汀以及联合使用小剂量阿托伐他汀+依折麦布的降脂效果相似，但联合治疗未能降低血清MMP-2、MMP-9和TIMP-1的水平。

关键词: 阿托伐他汀, 依折麦布, 降脂, 基质金属蛋白酶

Abstract:

Objective To compare the effects of higher dosage of atorvastatin alone and combination of lower dosage of atorvastatin with ezetimibe on levels of lipid and metalloproteinases in patients with coronary artery disease. Methods Forty-two patients with coronary artery stenosis (50% to 70% stenosis) without stent replacement were selected, and were randomly divided into atorvastatin group (treated with 20 mg or 40 mg atorvastatin alone, n=19) and combined-therapy group (treated with 5 mg,10 mg atorvastatin and 10 mg ezetimibe, n=23). The levels of serum lipid, hepatic and renal functions, creatine kinase, metalloproteinase (MMP)-2, MMP-9 and tissue inhibitor of MMP-1 (TIMP-1) were detected 12 weeks after treatment. Results Twelve weeks after treatment, the level of LDL-C in atorvastain group was (1.94±0.49) mmol/L (37.82% decrease from baseline), and that in combined-therapy group was (1.92±0.54) mmol/L (38.26% decrease from baseline), and there was no significant difference between these two groups (P>0.05). Twelve weeks after treatment, the levels of MMP-2 and MMP-9 were significantly decreased and that of TIMP-1 was significantly increased compared with baseline levels in atorvastatin, while no such changes were detected in combined-therapy group. Conclusion In patients with coronary artery stenosis, combined therapy with lower dosage of atorvastatin and ezetimibe may lead to the same lipid-lowing effects compared with therapy with higher dosage of atorvastatin, but it may not result in a significant reduction in serum levels of MMP-2, MMP-9 and increase of TIMP-1.

Key words: atorvastatin, ezetimibe, lipid-lowing, metalloproteinases

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