急性冠脉综合征血浆基质金属蛋白酶9水平及介入治疗对其的影响  

Plasma level of matrix metalloproteinase-9 in patients with acute coronary syndrome and its percutaneous coronary intervention

作　　者：张美燕[1] 郑兴[1] 秦永文[1] 丁继军[1] 赵仙先[1] 徐荣良[1] 

机构地区：[1]第二军医大学长海医院心血管内科,上海200433

出　　处：《第二军医大学学报》2006年第10期1105-1109,共5页Academic Journal of Second Military Medical University

摘　　要：目的:通过测定冠心病患者介入治疗前后及正常对照者冠脉造影前后血浆基质金属蛋白酶9(MMP-9)水平,探讨MMP-9水平在评估冠状动脉粥样硬化斑块稳定性中的价值。方法:用ELISA法测定29例急性心肌梗死(AMI)、34例不稳定心绞痛(UAP)、27例稳定心绞痛(SAP)患者及28例正常对照者血浆MMP-9水平,同时用乳胶颗粒增强速率散射比浊法测定血清hs-CRP水平。结果:AMI组PCI术前血浆MMP-9水平为171.30 ng/ml,明显高于SAP组的52.00 ng/ml及正常对照组的52.75 ng/ml(P<0.01),UAP组的143.55 ng/ml明显高于SAP组及正常对照组(P<0.05)。AMI组的血清hs-CRP水平为5.260 mg/L,明显高于UAP组的2.040 mg/L、SAP组的1.070 mg/L及正常对照组的0.550 mg/L(P<0.01),UAP组高于SAP组(P<0.05)及正常对照组(P<0.01)。术后血浆MMP-9水平明显降低,AMI组MMP-9的变化值(ΔMMP-9)为135.40 ng/ml,明显大于SAP组的29.50 ng/ml及正常对照组的26.50 ng/ml(P<0.01),UAP组的103.50 ng/ml大于SAP组及正常对照组(P<0.05)。hs-CRP水平与MMP-9水平呈正相关,两者与Gensini评分及病变支数间无相关性。结论:hs-CRP、MMP-9可作为预测斑块稳定性的指标,PCI术后血浆MMP-9的降低可能与心肌缺血及炎症改善有关。Objective,To determine the plasma MMP-9 levels in patients with coronary heart disease before and after percutaneous coronary intervention （PCI） and in healthy controls before and after coronary angiography, so as to assess the value of MMP-9 in evaluating the plaque stability in atherosclerosis. Methods： The plasma MMP 9 levels were determined by EI,ISA in 29 patients with acute myocardial infarction （AMI）, 34 patients with unstable angina （UAP）, 27 patients with stable angina （SAP）, and 28 healthy controls. Meanwhile, their serum hs-CRP levels were measured by particle-enhanced immunonephelometry. Results： The baseline level of MMP 9 was higher in AMI group （171.30 ng/ml） than those in SAP （52.00 ng/ml, P〈0.01） and control （52.75 ng/ml, P〈0.01） groups, and was higher in UAP group （143.55 ng/ml） than those in SAP and the control groups （P〈0.05）. The serum level of hs-CRP was higher in AMI group （5.260 mg/L） than those in UAP （2.040 mg/ L, P〈0.01）, SAP （1. 070 mg/L, P〈0.01）, and the control （0. 550 mg/L, P〈0.01） groups, and was higher in UAP group than those in the SAP （P〈0.05） and the control groups （P〈0.01）. The levels of MMP 9 were obviously decreased after operation. The change of MMP-9 （AMMP-9） in AMI group （135.40 ng/ml） was more obvious than those in SAP （29.50 ng/ml, P〈0.01） and the control （26.50 ng/ml, P〈0.01） groups. AMMP-9 in UAP （103.05 ng/ml） group was more obvious than those in SAP and the control groups （P〈0.05）. The plasma levels of MMP 9 were positively correlated with the levels of hs-CRP; neither MMP 9 nor hs-CRP was correlated with Gensini score or the number of diseased arteries. Conclusion.. Plasma lev els of MMP-9 and hs-CRP can be used for evaluation of plaque stability in coronary atherosclerosis. The post-PCI decrease of plasma MMP-9 level may be related to the improvements of ischemia and inflammation.

关 键 词：急性冠脉综合征 基质金属蛋白酶-9 超敏反应 C反应蛋白 

分 类 号：R541.4[医药卫生—心血管疾病]