罗格列酮对冠心病合并2型糖尿病患者MMP的影响.doc

罗格列酮对冠心病合并2型糖尿病患者MMP的影响 作者:李国洪,历伟民,王新鸣 作者单位：浙江省东阳市人民医院,浙江 东阳 322100 【摘要】 目的：研究罗格列酮治疗冠心病合并2型糖尿病患者时血清基质金属蛋白酶（MMP）-2、9的变化，以探讨罗格列酮减少动脉粥样硬化（AS）炎症反应、稳定斑块的作用机制。方法：选取冠状动脉造影证实的冠心病患者62例，其中单纯冠心病者34例，合并2型糖尿病者28例，两组均给予血管紧张素转化酶抑制剂、硝酸脂类、抗血小板等常规治疗，合并2型糖尿病者给予口服罗格列酮4 mg， 2次/d，共12周；比较两组间及治疗前、后MMP-2及9含量变化。结果：与单纯冠心病患者比，冠心病合并2型糖尿病患者血浆中MMP-2及MMP-9水平明显升高（P001）；经罗格列酮治疗12周后血清MMP-2、9水平较治疗前明显降低（P001）。结论：罗格列酮可降低冠心病合并糖尿病患者血清MMP-2及9水平，从而可减少冠状动脉粥样斑块基质成分的降解和炎症反应，起到稳定动脉粥样硬化斑块的作用。 【关键词】 冠状动脉疾病 糖尿病 基质金属蛋白酶类 罗格列酮 Effect of PPARΓ-activator rosiglitazone treatment on MMP level in coronary artery disease patient with type 2 diabetic/LI Guo|hong,LU Liang,LI Wei|min,WANG Xin|ming,JIN Mei|juan//Chinese Journal of Cardiovascular Rehabilitation Medicine,2007,16(3):262 Abstract：Objective:To investigate the matrix metalloproteinase(MMP) levels in coronary artery disease (CAD) patients with or without diabetic.Methods:The 28 CAD patients with diabetic received rosiglitazone 4 mg (twice daily) above routine therapy of CAD and 34 CAD patients received routine therapy of CAD alone for 12 weeks.The level of MMP-2 and 9 were detected before and after treatment.Results:Compared with CAD patients without diabetics,the serum MMP-2 and -9 leveIs were significantly higher in CAD patients with type 2 diabetic（P001）.Rosiglitazone treatment significantly reduced MMP-9 levels after 4 weeks (P001), and levels sustained until the end of the study(12 weeks).Conclusion:The MMP-2 and 9 levels increased in CAD patients with type 2 diabetic,and treatment of rosiglitazone may significantly reduces MMP-2、9 levels,so it may has anti|inflammatory and potential antiatherogenic effects. Author′s　address：Renmin Hospital of Dongyang,Dongyang,Zhejiang,322100,China Key words：Coronary artery disease;Diabetes;Matrix metalloproteinases;Rosiglitazone 糖尿病患者发生动脉粥样硬化（AS）的几率较正常人明显增加[1]。研究表明，基质金属蛋白酶-9在细胞外基质降解，纤维帽破裂过程中起着重要作用[2，3]。最近研究发现，罗格列酮是一种具有高度选择性和高效的过氧化物酶体增殖体激活受体Γ（PPARΓ）的激动剂，作为