摘要
目的观察通心络胶囊对不稳定型心绞痛（UAP）患者血浆基质金属蛋白酶-2／9（MMP-2／9）水平的影响，初步探讨其治疗UAP的可能作用机制。方法采用前瞻性研究方法。将2010年2月至2011年6月本院收治的110例UAP患者按随机数字表法分为通心络组（58例）和常规组（52例）。常规组给予阿司匹林＋辛伐他汀＋硝酸酯类；通心络组在常规组药物治疗基础上加用通心络胶囊3粒（0．26g／粒），每日3次。同期选择100例年龄匹配的本院健康查体者作为健康对照。采用酶联免疫吸附试验（ELISA）测定患者治疗前及治疗1、2、3个月后的MMP-2／9浓度。结果UAP患者MMP-2／9（μg／L）水平均明显高于健康对照组（MMP-2：448．09±11．90比215．56±14．74。MMP-9：624．94±12．12比384．41±21．74，均P〈0．01）。通心络组与常规组治疗前MMP-2／9浓度相近（MMP-2：450．32±11．20比445．96±12．26，MMP-9：625．92±13．17比623．99±11．07，均P〉0．05）；随治疗时间延长，两组治疗后MMP-2／9水平均较本组治疗前一时间点明显降低（均P〈0．01），且通心络组降低程度明显大于同期常规组（P〈0．05或P〈0．01），以治疗3个月后降低更显著（MMP-2：281．74±21．15比363．17±14．19，MMP-9：407．83±10．05比523．05±9．78，均P〈0．01）。通心络组总有效率明显高于常规组（91．4％比76．9％，P〈0．05）。结论通心络胶囊具有稳定动脉粥样斑块，减轻患者临床症状的作用，其作用机制可能与降低UAP患者血浆的MMP-2／9水平有关。
Objective To explore the possible mechanism of treating unstable angina pectoris （UAP）with Tongxinluo （TXL） through observing the effect of TXL on plasma levels of matrix metalloproteinase-2/9 （MMP-2/9） in patients with UAP. Methods A perspective study was conducted. One hundred and ten cases of patients with UAP admitted into the hospital between February 2010 and June 2011 were randomly divided into a TXL group （58 cases） and a conventional group （52 cases）. The patients in conventional group were treated with aspirin ＋ simvastatin ＋ nitrates ; TXL group was treated with the above conventional treatment and additionally 3 TXL capsules （0.26 g/capsule）, 3 times per day was applied. In the mean time, 100 age-matched healthy cases who had taken medical checkup in our hospital were selected as healthy control. Enzyme-linked immunosorbent assay （ELISA） was used to measure MMP-2/9 concentrations of the patients before treatment and 1, 2, 3 months after treatment in both groups, respectively. Results The plasma levels of MMP-2/9 （μg/L） in UAP patients were significantly higher than those in normal control cases （MMP-2 ： 448.09±11.90 vs. 215.56±14.74, MMP-9 ： 624.94±12.12 vs. 384.41±21.74, both P〈0.01） ; before treatment, the levels of MMP-2/9 were not significantly different between the TXL group and conventional group （MMP-2：450.32±11.20 vs. 445.96±12.26, MMP-9：625.92±13.17 vs. 623.99±11.07, both P〉0.05）. As the treatment progressed longer, the MMP-2/9 concentrations in both patient groups became lower compared to those before the treatment （all P〈0.01 ） ; moreover, the MMP-2/9 concentrations in the TXL group were significantly lower than those in the conventional group after treatment for 1, 2 and 3 months respectively （P〈0.05 or P〈0.01）, the most significant effect being at the time point of 3 months after treatment （MMP-2 ： 281.74±21.15 vs. 363.17±14.19, MMP-9：407.83±10.05 vs. 523.05±9.78, both P〈0.01）. The total effective rate in TXL group was higher than that in the conventional group （91.4% vs. 76.9%, P〈0.05）. Conclusion TXL has the effect of stabilizing plaque of atherosis and relieving the clinical symptoms of patients with UAP, and its mechanism is possibly related to the reduction of plasma levels of MMP-2/9 in such patients.
出处
《中国中西医结合急救杂志》
CAS
北大核心
2012年第6期336-339,共4页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
广西自然科学基金项目（桂科自0832150）
