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《不同劑量瑞舒伐他汀早期治療對急性冠脈綜合征pci術(shù)后單核細(xì)胞mmp-9表達的影響》由會員上傳分享,免費在線閱讀,更多相關(guān)內(nèi)容在學(xué)術(shù)論文-天天文庫。
1、安徽醫(yī)科大學(xué)碩士論文均接受常規(guī)冠心病二級預(yù)防治療[包括:阿司匹林、氯吡格雷、并根據(jù)病情加用倍他樂克、血管緊張素轉(zhuǎn)換酶抑制劑(ACEI)/血管緊張素Ⅱ受體拮抗劑(ARB)、低分子肝素藥物等],在上述治療基礎(chǔ)上根據(jù)性別、年齡、是否合并高血壓和2型糖尿病按按隨機序貫平衡系數(shù)法接受瑞舒伐他汀l0mg、20mg治療,并在治療期間保持飲食控制。入院后2~4d內(nèi)采用經(jīng)橈動脈途徑行CAG檢查:ACS組嚴(yán)重冠脈狹窄符合支架植入術(shù)標(biāo)準(zhǔn)(支架植入術(shù)根據(jù)《中國經(jīng)皮冠脈介入治療指南2011》),均成功植入1~3枚藥物洗脫支架,PCI術(shù)后瑞舒伐他汀原量維持治療;CAG檢查的正?;颊邽閷φ战M,術(shù)后停用冠
2、心病二級預(yù)防及任何調(diào)酯藥物治療。所有患者均于術(shù)前、術(shù)后24h及術(shù)后7d分別取血測血糖、肝腎功能、總膽固醇、甘油三酯、及低密度脂蛋白膽固醇的濃度,MMP-9ELISA試劑盒測定外周血MMP-9蛋白濃度;RT-PCR檢測外周血MMP-9mRNA的表達水平。結(jié)果:(1)ACS組外周血單核細(xì)胞MMP-9mRNA及蛋白表達水平明顯高于對照組,差異有統(tǒng)計學(xué)意義(P<0.05);(2)ACS組外周血單核細(xì)胞MMP-9表達水平在術(shù)后24h開始降低,術(shù)后7d降低更加顯著,較術(shù)前差異有統(tǒng)計學(xué)意義(P<0.05),瑞舒伐他汀20mg組較10mg組MMP-9表達降低更加明顯,差異有統(tǒng)計學(xué)意義(P<
3、0.05);(3)ACS組術(shù)前、術(shù)后24h、術(shù)后7d血脂各指標(biāo)比較,差異無統(tǒng)計學(xué)意義(P>0.05)。結(jié)論:ACS組外周血單核細(xì)胞MMP-9表達較對照組明顯增加,可能直接參與了不穩(wěn)定斑塊的形成及破裂;早期強效瑞舒伐他汀治療可有效下調(diào)ACS外周血單核細(xì)胞MMP-9的表達,呈劑量依賴性,起到調(diào)脂外抗炎和穩(wěn)定斑塊的作用。關(guān)鍵詞:急性冠脈綜合征;血管成形術(shù),經(jīng)腔,經(jīng)皮冠狀動脈;瑞舒伐他??;基質(zhì)金屬蛋白酶-95安徽醫(yī)科大學(xué)碩士論文EarlyDifferentDoseofRasuvastatainInfluenceontheExpressionsofMMP-9inCirculating
4、MonocytesafterPercutaneousCoronaryInterventioninPatientswithAcuteCoronarySyndromeAbstractObjectiveToevaluationtheeffectsofearlydifferent-doseofrosuvastatainonMMP-9incirculatingmonocytesafterpercutaneouscoronaryintervention(PCI)inpatientswithnoST-segmentelevationacutecoronarysyndrome(ACS).M
5、ethods75caseswererecruitedinthestudy,accordingtoclinicalmanifestationsanddiagnosticcoronaryangiography,the50patientswithnoST-segmentelevationACSwhounderwentPCIwererandomlydividedintotwogroups:Rosuvastatain10mg(n=25)and20mg(n=25)treatedbasicwithroutinetreatment[Aspirin,Clopidogrel,andthecon
6、ditionofpatientswithACEI/ARB,LMWH,dietcontrolatthesametimeduringtreatment],and25controlswithoutcoronaryheartdisease(CHD)wereincludedinthiscross-sectionalstudy.AllpatientsCAGcheckswithin2~4daysafteradmission,1~3drug-elutingstentsweresuccessfullyimplantedintheACSgroup,andoriginalamountRosuva
7、statintreatmentpostoperativePCI.Thenormalpatientsforthecontrolgroup,postoperativeCAGstopusingrosuvastatinandanyotherroutinetreatment.TheMMP-9proteinconcentrationweredetectedbyenzyme-linkedimmunosorbentassay(ELISA)beforePCIandat24hours,7daysafterPCI,andtheblood