CAJ | 학술논문

目的:探讨MMP-9在针刺防治急性颈动脉粥样硬化性脑梗死中的可能作用机制.方法:将64例符合纳入标准的急性颈动脉粥样硬化性脑梗死伴有高脂血症的患者随机分为治疗组和对照组;治疗组32例,对照组29例(脱落3例),两组均采用常规治疗;治疗组加用针刺治疗,对照组加用阿托伐他汀治疗.检测两组患者不同时间点血脂水平和血清MMP-9的变化.结果:1)两组患者治疗后4周,TC、LDL-C水平显著下降(P<0.05),TG变化不明显;治疗组对TC、LDL-C水平的影响与对照组疗效相当.2)两组患者MMP-9水平在治疗前均有较高表达,具有可比性(P>0.05);治疗后2周,其水平均有所降低,但治疗组较治疗前降低更明显(P<0.05),两组间比较有统计差异(P<0.05);治疗后4周,两组患者血清MMP-9水平较治疗前明显降低(P<0.05),组间比较差异显著(P<0.05).结论:1)针刺可有效改善颈动脉粥样硬化性脑梗死患者的TC、LDL水平,继而减缓动脉粥样硬化的脂质堆积、促进斑块消退;2)针刺可明显降低患者血清MMP-9水平,减轻对斑块内Ⅳ型胶原的降解、促进斑块稳定,进而发挥其防治脑梗死的作用.
목적:탐토MMP-9재침자방치급성경동맥죽양경화성뇌경사중적가능작용궤제.방법:장64례부합납입표준적급성경동맥죽양경화성뇌경사반유고지혈증적환자수궤분위치료조화대조조;치료조32례,대조조29례(탈락3례),량조균채용상규치료;치료조가용침자치료,대조조가용아탁벌타정치료.검측량조환자불동시간점혈지수평화혈청MMP-9적변화.결과:1)량조환자치료후4주,TC、LDL-C수평현저하강(P<0.05),TG변화불명현;치료조대TC、LDL-C수평적영향여대조조료효상당.2)량조환자MMP-9수평재치료전균유교고표체,구유가비성(P>0.05);치료후2주,기수평균유소강저,단치료조교치료전강저경명현(P<0.05),량조간비교유통계차이(P<0.05);치료후4주,량조환자혈청MMP-9수평교치료전명현강저(P<0.05),조간비교차이현저(P<0.05).결론:1)침자가유효개선경동맥죽양경화성뇌경사환자적TC、LDL수평,계이감완동맥죽양경화적지질퇴적、촉진반괴소퇴;2)침자가명현강저환자혈청MMP-9수평,감경대반괴내Ⅳ형효원적강해、촉진반괴은정,진이발휘기방치뇌경사적작용.
Objective:To investigate the action mechanism of MMP-9 in the prevention and treatment of acute carotid atherosclerotic cerebral infarction.Methods:64 patients with acute carotid atherosclerosis cerebral in-farction accompanying hyperlipidemia were randomly divided into a treatment group and a control group,with 32 cases in the treatment group and 29 cases in the control group ( shedding 3 cases) .Two groups were treated with conventional therapy and the treatment group was additionally with acupuncture, and the control group was additionally with atorvastatin.The level of blood lipid and serum MMP-9 was detected at different time points in two groups.Results:1)The level of TC and LDL-C was significantly decreased (P<0.05), and the change of TG was not obvious after 4 weeks'treatment in two groups;the effect of treatment group on the level of LDL-C and TC was similar to that of the control group.2)The level of serum MMP-9 in two groups was significantly higher than that before treatment,and the two groups were comparable ( P>0.05); after 2 weeks'treatment,the level of serum MMP-9 in two groups was decreased, but the treatment group was signifi-cantly lower than that before treatment ( P<0.05) ,and the difference between two groups was statistically sig-nificant (P<0.05);after 4 weeks'treatment, the level of serum MMP-9 in two groups was significantly low-er than that before treatment (P<0.05),and the difference between two groups was significant (P<0.05). Conclusion:1 ) Acupuncture can effectively improve the level of TC and LDL in patients with carotid atheroscle-rotic cerebral infarction,and can slow down the accumulation of lipid in atherosclerosis and promote plaque re-gression;2) Acupuncture can significantly reduce the level of serum MMP-9 in patients,and can alleviate the degradation of collagen-IV in plaque, promote plaque stability,and play a role in prevention and treatment of cerebral infarction.