MMPs与早期行PCI的NSTEMI患者左室重构相关  

Relationship between matrix metalloproteinase changes and non-ST-elevation myocardial infarction patients treated with early percutaneous coronary intervention

作　　者：王守力[1] 孙飞[2] 陈力量[3] 冯国斌[4] 金菲菲[5] 闫承慧[1] 韩雅玲[1] 

机构地区：[1]沈阳军区总医院心内科,辽宁沈阳110016 [2]沈阳军区大连210医院心内科,辽宁大连116021 [3]安徽医科大学附属安庆医院老年病科,安徽安庆246001 [4]泗阳县人民医院心内科,江苏泗阳234300 [5]辽宁医学院研究生院,辽宁沈阳121001

出　　处：《心脏杂志》2011年第2期214-217,共4页Chinese Heart Journal

基　　金：辽宁省自然科学基金资助项目(20082074)

摘　　要：目的:探讨早期行冠状动脉介入治疗(PCI)的非ST段抬高型心肌梗死(NSTEMI)患者血浆中金属基质蛋白酶(MMPs)的时间变化规律及与心肌梗死(MI)后左心室重构的相关性。方法:成功随访12个月的早期行PCI的NSTEMI患者126例,于入院即刻、发病后2 d、4 d、2周、4周抽取外周静脉血,ELISA检测血浆中MMP-2和MMP-9的浓度。PCI术后患者临床随访12个月,对比入院时及术后12个月心脏超声图,分析左室舒张末期容积(LVEDV)和左室射血分数(LVEF)的变化及与MMPs的相关关系。结果:①MI后2周的时间内,血浆中MMP-2的浓度随着MI时间的延长而不断升高,其后MMP-2的浓度开始下降;MMP-9的浓度在MI后4 d时达到最高,其后MMP-9浓度开始明显下降。②同入院时相比,MI后12个月后LVEDV明显扩大,完成随访的患者LVEDV扩大(11±4)ml。LVEF明显降低,降低(9±3)%。MI后2 d时的MMP-9的浓度与ΔLVEDV呈正相关,与ΔLVEF的相关关系不明显。4 d时的MMP-9值与12个月后的ΔLVEDV和ΔLVEF呈正相关;MI后2周和4周MMP-2的浓度与12个月后的ΔLVEDV和ΔLVEF呈正相关。结论:NSTEMI患者MI后4 d的MMP-9和2周的MMP-2浓度与短期内左心室重构及左心室功能具有明显相关性。AIM： To study the time-related changes of matrix metalloproteinases（MMPs） and the relationship between MMPs and left ventricular（LV） remodeling in patients with non-ST-elevation myocardial infarction（NSTEMI） treated with early percutaneous coronary intervention（PCI）.METHODS： A 12-month follow-up was conducted in 126 NSTEMI patients treated with early PCI.Plasma MMP-2 and MMP-9 were assayed at intervals（2 days,4 days,2 weeks and 4 weeks） in NSTEMI patients.The serial changes of LVEDV and LVEF were measured by echocardiography at baseline and 12 months,and the relationship between MMP-2,-9 and LVEDV and LVEF after NSTEMI was analyzed.RESULTS： MMP-2 concentrations substantially increased throughout the post-MI 2 weeks and then began to drop.MMP-9 concentration increased at 2 and 4 days after MI and dropped subsequently.MMP-9 concentration at 2 days after MI was positively correlated with ΔLVEDV（r=0.350,P=0.028） and MMP-9 concentration at 4 days after MI was positively correlated with ΔLVEDV（r=0.402,P=0.000） and ΔLVEF（r=0.333,P=0.040）.MMP-2 concentrations at 2 weeks and 4 weeks after MI were positively correlated with ΔLVEDV（2 weeks,r=0.378,P=0.010;4 weeks,r=0.331,P=0.041） and ΔLVEF（2 weeks,r=0.501,P=0.000;4 weeks,r=0.367,P=0.014）.CONCLUSIONS： Plasma MMP-9 concentrations at 4 days after NSTEMI and MMP-2 concentrations at 2 weeks and 4 weeks after NSTEMI are correlated with LV remodeling.

关 键 词：心肌梗死 非ST段抬高型 左心室重构 金属基质蛋白酶 

分 类 号：R541.4[医药卫生—心血管疾病]