【摘要】 目的 观察联用阿托伐他汀与卡托普利对急性冠脉综合征(acute coronary syndrome，ACS)患者的近期疗效及可能机制研究。方法 选取ACS患者90例,按就诊顺序随机双盲分为阿托伐他汀治疗组和卡托普利 + 阿托伐他汀治疗组，疗程4周，疗程结束后测定上述病例血清中肿瘤坏死因子-α(tumor necrosis factor-α，TNF-α)和基质金属蛋白酶-9(matrix metalloproteinase-9， MMP-9)的水平变化，观察两治疗组4周内主要终点事件发生情况，并进行统计学分析。结果 ACS患者血清TNF-α和MMP-9的水平明显高于对照组；卡托普利 + 阿托伐他汀治疗组在治疗4周后血清TNF-α和MMP-9的水平明显低于阿托伐他汀治疗组，主要终点事件也有所下降。结论 阿托伐他汀与卡托普利联用与单用阿托伐他汀比较，可通过更为显著降低TNF-α和MMP-9水平，达到控制炎症，减少粥样斑块基质成分的降解，改善ACS近期疗效的作用。

【关键词】 急性冠脉综合征; 阿托伐他汀; 卡托普利; 基质金属蛋白酶-9; 肿瘤坏死因子-α

 

The short period effects and mechanism investigation of atorvastatin added with captopril in patients with acute coronary syndromes HU Bo, Li Jian Guo Intensive Care Unit, Zhongnan Hospital of Wuhan University, Wuhan 430071，Hubei, China

【ABSTRACT】Objective To explore the short period effects and mechanism investigation of atorvastatin added with captopril in patients with acute coronary syndromes (ACS). Methods The 90 patients with ACS were randomly assigned in a double-blind manner to receive atorvastatin or atorvastatin added with captopril. After 4 weeks, The serum levels of TNF-α and MMP-9 were compared among all groups and the primary composite end point events were observed in two treat groups. Results Serum levels of TNF-αand MMP-9 were significantly higher in the ACS group than in the control group;Compared with atorvastatin treatment group,the atorvastatin added with captopril treatment group had a significantly decrease in serum level of TNF-αand MMP-9,and reduced tendency of primary composite end point events after 4 weeks treatment.Conclusion atorvastatin added with captopril could significantly lower the serum levels of TNF-αand MMP-9 compared with atorvastatin only, so it could reduce the inflammation,decrease the breakdown of matrix collagen, and have a beneficial short effect on  ACS.

【Key words】ACS; atorvastatin; captopril; MMP-9; TNF-α