阿托伐他汀治療對(duì)急性冠脈綜合征患者血清sCD40、sCD40L和MMP—9的影響

摘要：目的 探討急性冠脈綜合征患者血清血清sCD40、sCD40L和MMP-9的變化，以及阿托伐他汀治療對(duì)其的影響，初步探討阿托伐他汀對(duì)急性冠脈綜合征的預(yù)防與治療機(jī)制。方法 將120例急性冠脈綜合征患者隨機(jī)分為A組（n=60）和B組（n=60），A組常規(guī)治療，B組在常規(guī)治療基礎(chǔ)上加服阿托伐他汀，在治療前后分別測(cè)定每組患者血清sCD40、sCD40L和MMP-9水平。結(jié)果 急性冠脈綜合征血清sCD40、sCD40L和MMP-9水平較對(duì)照組顯著升高（P<0.05）；B 組治療后較治療前及A組治療后血清sCD40、sCD40L和MMP-9顯著降低（P<0.05），A 組治療前后血清sCD40、sCD40L和MMP-9差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）。結(jié)論 血清sCD40、sCD40L和MMP-9可能與急性冠脈綜合征發(fā)生發(fā)展有關(guān)，阿托伐他汀能顯著降低急性冠脈綜合征患者sCD40、sCD40L和MMP-9水平，治療急性冠脈綜合征的機(jī)制可能與調(diào)節(jié)血清sCD40、sCD40L和MMP-9水平有關(guān)。

關(guān)鍵詞：阿托伐他汀；急性冠脈綜合征；sCD40L；sCD40L；MMP-9

Effect of atorvastatin on the levels of sCD40L，sCD40L and MMP-9 in patients with acute coronary syndrome

CHEN Fang

（Department of cardiology，Yiyang Central Hospital，Yiyang 413000， Hunan，China）

Abstract：Objective To explore the change of atorvastatin on acute coronary syndrome patients and the impacts on the expressions of sCD40L，sCD40L and MMP-9， to study the mechanism for its prevention and treatment of acute coronary syndrome. Methods The clinica1 observation of using randomized contro1ed method，120 cases of acute coronary syndrome patients were divided into A and B group. The group A were treated only with conventional therapy， The group B was given atorvastatin besides conventional therapy. And the concentrations of sCD40L，sCD40L and MMP-9 in serum were detected before and after therapy. Results The level of serum sCD40L、sCD40L and MMP-9 in ACS patients were significant increase as to control group（all P<0.05）， and The serum level of sCD40L，sCD40L and MMP-9 on B group after treatment were lower than those before treatment and A group after treatment（P<0.05）， while the serum level of sCD40L，sCD40L and MMP-9 on A group after treatment were no significantly different with those before treatment （P>0.05）. Conclusion There may be a relevant between serum sCD40L， sCD40L，MMP-9 and the incidence of acute coronary syndrome， atorvastatin can significantly reduce the levels of sCD40L，sCD40L，MMP-9 in acute coronary syndrome patients， the mechanism of atorvastatin treat acute coronary syndrome may be related to regulating the serum level of sCD40L，sCD40L and MMP-9.

Key words：Atorvastatin；Acute coronary syndrome；sCD40L；sCD40L；MMP-9

急性冠脈綜合征（Acute coronary syndrome，ACS） 是急性嚴(yán)重的心肌缺血性心臟猝死的一種臨床綜合征， 以冠狀動(dòng)脈粥樣硬化斑塊破裂或侵蝕，繼發(fā)完全或不完全閉塞性血栓形成為病理基礎(chǔ)。近年來(lái)，越來(lái)越多的證據(jù)證明，動(dòng)脈粥樣硬化斑塊破裂的纖維帽局部有大量活化的巨噬細(xì)胞、泡沫細(xì)胞浸潤(rùn)，炎癥反應(yīng)加劇了斑塊的不穩(wěn)定性，炎癥反應(yīng)過(guò)程在ACS的發(fā)病機(jī)制中起重要作用[1]。研究發(fā)現(xiàn)，CD40與CD40L是一對(duì)互補(bǔ)跨膜糖蛋白，CD40與CD40L是免疫和炎性反應(yīng)中的重要信號(hào)轉(zhuǎn)導(dǎo)系統(tǒng)，介導(dǎo)一系列生物學(xué)效應(yīng)如分泌細(xì)胞因子、黏附分子、基質(zhì)金屬蛋白酶和組織因子等可能參與急性冠狀動(dòng)脈綜合征（ACS）的發(fā)生和發(fā)展，是炎癥免疫反應(yīng)的樞紐和炎癥調(diào)節(jié)的信號(hào)通路[2]。……