姜黄素对不稳定型心绞痛患者血清明胶酶水平的影响

The main pathophysiological basis of most unstable angina pectoris （UAP） is plaque rupture of coronary atherosclerosis complicated thrombosis. Gelatinases， including matrix metalloproteinase （MMP）-2 and MMP-9 is important member in the family of MMP and one of important factors that lead to rupture of coronary plaque. Curcumin is a phenol pigment ingredient extracted from rhizome of curcuma-a kind of Zingiberaceae plant. A lot of domestic and oversea researches found that curcumin possesses a variety of pharmacological activities such as anti-inflammation， anti-oxidation， modulation of lipid， anti-tumor and anti-atherosclerosis and so on[1]， but there is few research about its effect on unstable plaque. This study was to observe the change of serum levels of gelatinases before and after curcumin treatment in order to investigate effect of curcumin on unstable plaque in UAP patients.1　 Clinical data1.1　SubjectsA total of 80 UAP patients admitted in first affiliated hospital of Jiamusi university from January 2010 to September 2010 were enrolled， they were consistent with the diagnostic standard of UAP formulated by European Society of Cardiology and American College of Cardiology in 2007; and randomly divided into curcumin treatment group [40 cases （18 male and 22 female）， mean age was （62±10.5） years] and routine treatment control group [ 40 cases （17 male and 23 female）， mean age was （64±11.4） years ]. Patients with following diseases were excluded： acute/chronic infective diseases， severe liver/renal dysfunction， operation/wounded in the near period， tumor and autoimmune diseases.1.2　TreatmentBoth the two groups were given standard fundamental treatment， including drugs of modulation of lipid， anticoagulation， antiplatelet and nitrates. Curcumin treatment group were given curcumin capsules additionally， 100mg each time after breakfast， lunch and supper， oral.1.3　Detection of samplesAll patients were taken 5ml blood sample from ulnar vein on an empty stomach by morning before and 30d after treatment. After standing at room temperature for 30 min， the samples were centrifuged at 3000r/min for 10 min. Then the serum was saved in fridge at -30 ℃ for detection. Enzyme linked immunosorbent assay （ELISA） was used to measure serum levels of MMP-2 and MMP-9. Concrete steps were performed strictly according to the instruction. All kits were bought from Dalian Fanbang technology limited company.1.4　Statistical treatmentThe SPSS 15.0 statistical software was used to perform statistical treatment. Measurement data were showed as mean±standard deviation（x-±s）， t test was used to perform comparison between groups. Paired t test was used to perform self comparison before and after treatment. Numeration data were analyzed with chi-square test. P<0.05 was regarded as possessing significant difference.2　Results2.1　Comparison of general data between the two groupsAs shown in the table 1， there were no significant difference in age， gender and risk factors between two groups （P>0.05）， and it indicated that the two groups were comparable.2.2　Comparison of change of MMP-2 and MMP-9 between the two groupsAfter treatment， serum levels of MMP-2 and MMP-9 significantly decreased in curcumin treatment group compared with before treatment （P<0.01） and those of routine treatment group （P<0.05）， it was shown in Table 2.Table 1　Comparison of general data between the two groups　　　Table 2　Comparison of serum levels of MMP-2 and MMP-9 between the two groups before and after treatment3　DiscussionRupture of unstable artery atheromatous plaque is the most direct cause of UAP. Gelatinases can degrade extracellular matrix ingredients such as collagen type Ⅳ and elastin in the fibrous cap， and leads fibrous cap to be thinner and plaque becomes unstable and easy to break. A lot of researches found that increase of serum levels of gelatinases indicated instability of plaque. How to inhibit the expressions of gelatinases in order to stabilize atheromatous plaque has become a hotspot of study.Curcumin possesses wide pharmacological effects， relative wide sources; it is cheap and has few adverse reactions. Lin HS et al.[2] found that curcumin could improve aortic atherosclerosis and down regulate expression of MMP-9 in atheromatous plaque on aortic artery walls in rabbits. Shi YH et al.[3] found that application of curcumin capsules based on routine western medicinal treatment can significantly improve syndromes of angina pectoris and lower serum level of MMP-9 in patients with UAP. Zhang J et al.[4] found that curcumin can inhibit expression of MMP-9 in human umbilical vein endothelial cells cultured in vitro and remodelling of extracellular matrix， thus enhance stability of plaque. Chen SB et al.[5] found that curcumin can inhibit expressions of MMP-2 and MMP-9 in experiment of heart failure model in rabbits.Our study found that curcumin taken orally based on routine treatment can significantly lower serum levels of gelatinases in UAP patients and more than that of pure application of routine drug treatment （P<0.05）。 So it indicated that curcumin may stabilize atheromatous plaque and decrease the incidence of cardiovascular events in UAP patients，may be to spread.【参考文献】[1]龙明智，陈磊磊。姜黄素的药理作用[J].国外医学：中医中药分册，2003,25（5）：270-272.[2]林海瑟，陈碧新，赵志光，等。姜黄素对动脉粥样硬化兔基质金属蛋白酶9的影响[J]. 中国动脉硬化， 2007， 15（3）： 189-192.[3]石英辉，郭炳彦，韩　瑞，等。姜黄素胶囊对不稳定型心绞痛患者血清基质金属蛋白酶-9水平的影响[J]. 现代中西医结合杂志，2010,19（1）33-34.[4]张　筠，王宗仁，刘镘利。姜黄素对人脐静脉内皮细胞基质金属蛋白酶-9的影响[J].中药新药与临床药理， 2008， 19（2）：97-99.[5]陈少伯，王东琦，李玉明，等。姜黄素对压力超负荷兔心肌基质金属蛋白酶表达及胶原重构的作用[J].中国新药与临床杂志，2005,24（3）：189.