阿托伐他汀对急性颈内动脉系统脑梗死患者基质金属蛋白酶-9的影响

目的 观察阿托伐他汀对急性脑梗死患者血清基质金属蛋白酶-9（matrix metalloproteinase-9，MMP-9）的影响。方法 入选急性脑梗死患者128例，根据入院后颈动脉彩超结果，分为颈动脉粥样硬化（atherosclerosis，AS）稳定斑块组51例、颈动脉AS易损斑块组46例，无斑块组31例。各组给予阿托伐他汀20mg/d口服干预治疗，疗程2周。比较治疗前及治疗2周后患者血清MMP-9水平变化。结果 ①治疗前易损斑块组和稳定斑块组血清MMP-9浓度分别为（419.93±113.12）μg/L和（271.45±80.34）μg/L，均高于无斑块组（147.36±23.62）μg/L，易损斑块组也高于稳定斑块组（均P＜0.01）。②阿托伐他汀治疗2周后易损斑块组、稳定斑块组及无斑块组血清MMP-9水平分别下降至（242.58±101.63）μg/L、（191.36±79.28）μg/L和（126.72±22.86）μg/L，与本组治疗前相比，差异具有统计学意义（均P＜0.01）。结论 急性脑梗死患者中血清MMP-9的水平与AS斑块的发生和稳定性相关，阿托伐他汀治疗能显著降低急性颈内动脉系统脑梗死患者MMP-9水平。

Influence of Atorvastatin on Serum Matrix Metalloproteinase-9 in Patients with Acute Cerebral Infarction in Anterior Circulation

Objective To observe the influence of atorvastatin on serum matrix metalloproteinases-9（MMP-9） in patients with acute cerebral infarction. Methods One hundred and twenty-eight patients with acute cerebral infarction in anterior circulation were divided into three subgroups according to the characteristic of carotid arteries atherosclerotic（AS） plaques, which were assessed by color doppler ultrasonography：stable plaque group（51 cases）, vulnerable plaque group（46 cases） and no plaque group（31 cases）. All patients received oral atorvastatin of 20 mg daily for 2 weeks. The levels of serum MMP-9 before and after treatment in patients were measured respectively. Statistic analysis was performed with SPSS11.5. Results The level of serum MMP-9 in vulnerable plaque group was （419.93± 113.12）lxg/ L and in stable plaque group was （271.45±80.34）μg/L before the treatment, it was significantly higher than （147.36±23.62）μg/L in no plaque group, and the level in vulnerable plaque group was also significantly higher than in stable plaque group（P〈0.01, respectively）. ②At the end of the two weeks after treatment with atorvastatin, the level of serum MMP-9 in three groups were （242.58±101.63）μg/L, （191.36±79.28） μg/L and （126.72±22.86）μg/L, it was significantly lower than the level in the same group before treatment （P〈0.01, respectively）. Conclusion The level of the serum MMP-9 in patients with acute cerebral infarction in anterior circulation is associated with the occurrence and stability of the carotid atherosclerosis plaques; Atorvastatin has effects on a marked reduction in MMP-9 level in patients with acute cerebral infarction in anterior circulation.