替米沙坦对不稳定型心绞痛患者血清hs-CRP、MMP-9和AngⅡ水平的影响

摘要

目的 探讨替米沙坦对不稳定型心绞痛患者血清高敏C-反应蛋白(hs-CRP)、基质金属蛋白酶-9(MMP-9)和血管紧张素Ⅱ(AngⅡ)水平的影响.方法 采用分层抽样法随机将100例不稳定型心绞痛患者分为常规治疗组(n=50)和替米沙坦组(n=50),替米沙坦在常规药物治疗的基础上联合应用替米沙坦治疗,分别测定两组患者在治疗前和治疗后6个月的空腹血糖、血脂、血压、血清hs-CRP、MMP-9及AngⅡ水平,并观察患者心血管事件的发生的率.结果 常规治疗组及替米沙坦组患者治疗后空腹血糖、血脂及血压均呈现不同程度改善,但两组间并无统计学差异(P＞0.05).两组患者血清hs-CRP、MMP-9及AngⅡ的水平在治疗前比较,差异无统计学意义(P＞0.05);在治疗6个月后两组血清hs-CRP、MMP-9的水平均呈降低趋势,但替米沙坦组较常规治疗组降低幅度更大,两组血清hs-CRP、MMP-9水平比较,差异具有统计学意义(P＜0.05),两组患者血清AngⅡ的水平在治疗6个月后均有所升高,但两组间比较差异无统计学意义(P＞0.05).常规治疗组心血管事件发生率(20.0%)高于替米沙坦组(8.0%),有统计学差异(P＜0.05).结论 替米沙坦能够降低不稳定型心绞痛患者血清hs-CRP和MMP-9的水平,稳定粥样斑块,改善患者预后.%Objective To investigate the influences of telmisartan on levels of serum high-sensitivity C-reac-tive protein ( hs-CRP ), matrix metalloproteinase-9 ( MMP-9 ) and angiotensin II ( Angll ) in patients with unstable angina pectoris ( UAP ). Methods All 100 patients with UAP were randomly divided into routine group ( n = 50 ) and telmisartan group ( n = 50 ) by using stratified sampling method. The levels of fasting plasma glucose, blood fat, blood pressure, serum hs-CRP, MMP-9 and Angll were detected respectively in two groups before and 6 months after the treatment. The occurrence rate of cardiovascular events was observed. Results The levels of fasting plasma glucose, blood fat and blood pressure were ameliorated after treatment but had no statistical difference in two groups ( P > 0. 05 ). The levels of serum hs-CRP, MMP-9 and Angll were not significantly different between two groups before treatment ( P > 0. 05 ), while the levels of serum hs-CRP and MMP-9 trended to decrease but the amplitude of decrease was higher in telmisartan group than that in routine group 6 months after treatment. The comparison of levels of serum hs-CRP and MMP-9 showed statistical significance between two groups ( P <0. 05 ). The level of Angll increased in two groups 6 months after treatment, but the difference was not statistical significant ( P >0. 05 ). The occurrence rate of cardiovascular events was higher in routine group ( 20. 0% ) than that in telmisartan group ( 8. 0% ,P <0. 05 ). Conclusion Telmisartan can reduce the levels of serum hs-CRP and MMP-9, stabilize atheromatous plaque and ameliorate prognosis in patients with UAP.