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目的探讨急性冠状动脉综合征(ACS)患者血清炎性因子变化及苯那普利稳定动脉粥样硬化斑块的可能机制。方法入选70例ACS患者为ACS组,并随机分为苯那普利治疗组40例和常规治疗组30例;同时又分稳定性心绞痛(SAP)组22例,对照组32例。比较各组Toll样受体4(TLR4)、TNF-α、基质金属蛋白酶9(MMP-9)表达差异及其相关性。结果 ACS组TLR4、TNF-α和MMP-9含量显著高于SAP组和对照组(P<0.01)。治疗4周后,苯那普利治疗组TLR4、TNF-α和MMP-9含量明显低于常规治疗组(P<0.05)。结论血管紧张素转换酶抑制剂苯那普利可能通过抑制ACS患者TLR4过度表达及其下游炎性细胞因子TNF-α和MMP-9分泌,稳定ACS易损斑块,改善其预后。
Objective To investigate the changes of serum inflammatory factors in patients with acute coronary syndrome (ACS) and the possible mechanism of benazepril in stabilizing atherosclerotic plaque. Methods Seventy ACS patients were enrolled as ACS group and were randomly divided into benazepril treatment group (n = 40) and routine treatment group (n = 30). Meanwhile, 22 patients were divided into stable angina pectoris group (SAP) and control group (32 patients). The differences of Toll-like receptor 4 (TLR4), TNF-α and MMP-9 in each group were compared and analyzed. Results The levels of TLR4, TNF-α and MMP-9 in ACS group were significantly higher than those in SAP group and control group (P <0.01). After 4 weeks of treatment, the levels of TLR4, TNF-α and MMP-9 in benazepril group were significantly lower than those in routine treatment group (P <0.05). CONCLUSION: Benazepril, an angiotensin converting enzyme inhibitor, may stabilize ACS vulnerable plaque and improve its prognosis by inhibiting TLR4 overexpression and its downstream inflammatory cytokines TNF-α and MMP-9 secretion.