冠状动脉粥样硬化性心脏病患者冠状动脉支架置入与血清金属蛋白酶2和金属蛋白酶9表达的关系  

Effect of percutaneous coronary intervention on the expressions of matrix metalloproteinase-2 and matrix metalloproteinase-9 in patients with coronary heart disease

作　　者：李昭[1] 李梦[1] 胡健[1] 

机构地区：[1]中国医科大学附属第一医院心内科,辽宁省沈阳市110001

出　　处：《中国组织工程研究与临床康复》2008年第17期3213-3216,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:研究表明金属蛋白酶与冠状动脉粥样硬化性心脏病(简称冠心病)支架置入后血管再狭窄有着密切关系。实验设立冠状动脉造影为对照,拟进一步分析冠状动脉支架置入与血清金属蛋白酶2和金属蛋白酶9表达的关系。方法:选择2006-06/12中国医科大学附属第一医院住院接受诊治冠心病患者50例。所有患者均符合1980年WHO关于冠心病的诊断标准。其中冠状动脉支架置入组25例,男13例,女12例;平均年龄(51.2±8.5)岁;单纯冠状动脉造影组为病变复杂不适于支架置入、择期行搭桥手术者25例,男14例,女11例;平均年龄(53.9±7.6)岁。分别于造影前或支架置入前1d,造影后或支架置入后第1,10,30天取两组患者静脉血,应用双抗体夹心酶联免疫吸附法检测血清金属蛋白酶2和金属蛋白酶9浓度。结果:单纯冠状动脉造影组手术前后各时间段血清金属蛋白酶2和金属蛋白酶9浓度差异无显著性意义(P>0.05);冠状动脉支架置入组术后第1,10,30天金属蛋白酶2和金属蛋白酶9的浓度持续升高,术后第10天高于术后第1天(P<0.05),术后第30天高于术后第10天(P<0.05)。结论:单纯冠状动脉造影不影响冠心病患者血清金属蛋白酶2和金属蛋白酶9表达。支架置入可导致金属蛋白酶2和金属蛋白酶9持续升高,是材料的血液相容性还是血管壁的持续刺激造成的,还需要实验进一步证明。AIM： Previous studies show that metalloprotease is highly correlated with vascular restenosis after percutaneous coronary intervention. In this study, with coronary arteriongraphy as control, we explore the effect of percutaneous coronary intervention on the expression of matrix metalloproteinase-2 （MMP-2） and MMP-9 in the patients with coronary heart disease. METHODS： Fifty patients with coronary heart disease were selected from First Hospital of China Medical University from June to December 2006. All patients were diagnosed according to the diagnostic criteria of coronary artery disease of WHO in 1980. Of them, there were 25 cases undergoing percutaneous coronary intervention, including 13 males and 12 females with an average age of （51.2±8.5） years; there were 25 cases undergoing coronary angiography and bypass graft surgery, including 14 males and 11 females with an average age of （53.9±7.6） years. Venous blood samples were obtained before and after coronary angiography or 1 day before and 1, 10, 30 days after percutaneous coronary intervention. Plasma concentrations of MMP-2 and MMP-9 were determined by Enzyme linked immunoassay. RESULTS： There were no significant differences in MMP-2 and MMP-9 concentrations of coronary angiography group at each time point （P 〉 0.05）. The concentrations of MMP-2 and MMP-9 were significantly increased on days 1, 10, and 30 after percutaneous coronary intervention, and those on day 10 were higher than on day 1 （P 〈 0.05）, and on day 30 were higher than on day 10 （P 〈 0.05）. CONCLUSION： Coronary angiography does not influence MMP-2 and MMP-9 expressions. Stent implantation can lead to increases in MMP-2 and MMP-9. Whether it is caused by material blood compatibility or continuous stimulation to vessel wall is still uncertain.

关 键 词：支架 金属蛋白酶2 金属蛋白酶9 

分 类 号：R541.4[医药卫生—心血管疾病]