| Objective: Atheromatous plaque rupture or desquamate and subsequent thrombosis are the main causes of cerebral infarction(CI). Matrix-metalloproteinases(MMPs) have the capability to degrade the extracellular matrix of the fibrous cap,predisposing to plaque rupture. Several lines of evidence suggest that MMP-9 could play a potential role in atheromatous plaque disruption of CI. Clinical trials have demonstrated that statin therapy reduces cerebralvascular events and mortality. In addition to the effects on lipid concentrations,stabilization of atherosclerotic plaques and attenuation of the inflammatory response may account for the clinical benefits of statins in CI. Animal experiments and clinical studies have shown that statins can stabilize plaque by increasing the collagen content and inhibiting metalloproteinases. The purpose of this study was to observe the influence of atorvastatin on serum matrix matalloproteiases-9(MMP-9), c-reactive protein(CRP) level in patients with cerebral infarction and also compared with healthy individual control after taking atorvastatin for 2 weeks,so we can study the benefits of statins of stabilization of atherosclerot- ic plaques and attenuation of the inflammatory response. Materials and methods:For this study,we enrolled 60 patients with CI with unnor- mal the serum level of the lipid (including 10 patients with the big area group and 20 patients with the middling area group and 30 patients with the small area group),who were in their first episode. Thirty healthy individuals who were age-and sex-matched with patients served as controls. The patients of CI received a combination of conventional therapy plus 20mg/day atorvastatin each evening for 2 weeks after onset of disease within with 48 hours. Conventional therapy included aspirin,betablocker,angiotensin converting enzymeinhibitor, low- mole -cularweight heparin. Peripheral venous blood was drawn in heparincontaining tubes after overnight fasting at baseline and after 2 weeks to detect the concentrations of the MMP-9,CRP,total cholesterol,triglyceritdes and LDL-cholesterol. MMP-9 wasdetermined using enzymelinked immunosorbent assay (ELISA) kits according to the manufacturer's instructions(R&D Systems). The CRP samples were analysed by latex particle- enhanced immuno turbidimetric assay. All the data are express- ed by x±s Comparisons between groups were analyzed by t-test(two-sided), P value<0.05(two-tailed) was considered statistically significant.Results:1. The concentrations of MMP-9 and CRP at base line: Patients with CI had higher plasma MMP-9 and CRP concentrations than the healthy individuals. (P<0.001); 2. The concentrations of MMP-9 and CRP of the patients with different areas CI with healthy individual: Patients with the big , the middling and small infarction area group and higher plasma MMP-9 and CRP concentrations than those of the healthy individuals (P<0.05 for the small infarction area group,P<0.001 for the middling and big infarction area group );3. Comparison of the concentrations of MMP-9 and CRP of the patients with different CI areas each other: Patients with the big, the middling infarction area group and higher plasma MMP-9 and CRP concentrations than the small area group(P<0.05 for the small and middling infarction area group; P<0.01 for the middling and big infarction area group; P<0.001 for the small and big infarction area group );4. The correlative between the MMP-9 level of the patients and the different areas CI: There were a positive correlative between MMP-9 and CI area values (r=0.433,P<0.001).5. The concentrations of MMP-9 before and after therapy: After 2 weeks,plasma MMP-9 had decreased significantly in there groups(P<0.05 for the small infarction area group,P<0.01 for the middling infarction area group, P<0.001 for the big infarction area group).6. The concentrations of CRP before and after therapy oneself: After 2 weeks, plasma CRP had decreased signifycantly in there groups(P<0.05 for the small infarction area group,P<0.01 for the middling infarction area group, P<0.001 for the big infarction area group). 7. The lipid level before and after therapy: After 2 weeks,total cholestero,triglycerides,and LDL-cholesterol concentrations were significant1y lower in all the patients with CI(P<0.05). HDL cholesterol concentradons increased significantly (P<0.05).Conclusions:1 The present investigation shows that plasma concentrations of MMP-9 and CRP in patients with CI are significantly higher than those in healthy individuals, suggests that MMP-9 and CRP could serve as powerful predictors of unstable atherosclerotic plaques and as an indicator for early diagnosis of the patients with CI.2 After 2 weeks therapy with atorvastatin,plasma MMP-9 and CRP had decreased significantly and total cholesterol, triglycerides, and LDL-cholester-of concentrateions were significantly lower in both groups received a therapy of atorvastatin. In addition to the effects on lipid concentrations,stabilization of atherosclerotic plaques and attenuation of the inflammatory response may account for the clinical benefits of statins in CI.
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