血清MMP9和MPO及sCD40L识别冠状动脉斑块性质的初步研究  

The preliminary study of the value of MMP9, MPO and sCD40L in detection of the characteristics of coronary artery plaque

作　　者：井娜[1] 吕滨[2] 康金锁[1] 张春玲[1] 鲁锦国[3] 张丽[1] 陈雄彪 侯志辉[2] 陈曦[1] 丛祥凤[1] 

机构地区：[1]中国医学科学院阜外心血管病医院临床检验中心,北京100037 [2]中国医学科学院阜外心血管病医院放射科,北京100037 [3]武汉亚洲心脏病医院心内科 [4]辽宁省金秋医院放射科

出　　处：《中华检验医学杂志》2011年第10期889-892,共4页Chinese Journal of Laboratory Medicine

基　　金：国家自然科学基金资助项目,国家十一五科技支撑计划课题资助项目

摘　　要：目的 探讨MMP9、MPO及sCD40L在识别冠状动脉斑块性质中的作用.方法 选取2008年4月至2010年1月阜外心血管病医院门诊胸痛患者118例,根据64排螺旋CT检查结果,将CT值＜130 Hu的患者入选为非钙化斑块组（71例）,CT值≥130 Hu的患者入选为钙化斑块组（47例）.选取90名健康体检者为对照组.采用ELISA检测血清MMP9、MPO及sCD40L水平,并比较其在各组中水平的差异.采用ROC曲线评价各标志物诊断非钙化斑块的敏感度和特异度.结果 非钙化斑块组血清MMP9、MPO、sCD40L水平分别为（762.25±368.71）、[844.10（582.00～ 1220.70）]、（9.37±3.15） μg/L,高于健康对照组的（342.70±178.53）、[426.35（283.20～592.00）]、（6.55±2.96） μg/L及钙化斑块组的（483.12±219.09）、[469.00（302.45～723.55）]、（7.24±2.86） μg/L,差异均有统计学意义（统计值分别为F =42.47,H=50.28,F=17.94,P均＜0.01）.MMP9、MPO及sCD40L识别非钙化斑块的ROC曲线下面积分别为0.854、0.792、0.751,当识别非钙化斑块的临界值分别为510.13、537.82、7.05 μg/L时,其诊断敏感度分别为80％、80％和80％,特异度分别为80％、67％和55％.结论 血清MMP9、MPO和sCD40L水平有助于判断冠状动脉斑块的性质.Objective To evaluate the utility of MMP9,MPO and sCD40L in detection of the character of coronary artery plaque.Methods From April 2008 to January 2010,118 patients from outpatient of Fu Wai Hospital with chest pain were enrolled.All of them underwent 64 Multiple-detector row spiral computer tomography （64-MDCT）,the CT value 〈 130 Hu patients were enrolled in non-calcified plaque group （71 cases）,CT value ≥ 130 Hu patients were enrolled in the calcified plaque group （47 cases）.Ninty healthy volunteers were selected as the control group.Enzyme-linked immunosorbent assay （ELISA） was used to detect the levels of serum markers,including MMP9,MPO and sCD40L.Levels of MMP9,MPO and sCD40L of each group were compared.ROC curve was used to evaluate the sensitivity and specificity of the markers in diagnosis of non-calcified plaque.Results MMP9,MPO and sCD40L levels of non-calcified were （ 762.25 ± 368.71 ）,[ 844.10 （582.00 - 1220.70） ],（9.37 ± 3.15） μg/L,higher than the healthy control group （342.70 ± 178.53）,[426.35 （ 283.20 - 592.00） ],（6.55 ± 2.96） μg/L and calcified plaque group （ 483.12 ± 219.09 ）,[ 469.00 （ 302.45 - 723.55） ],（ 7.24 ± 2.86） μg/L The difference was statistically significant （ F =42.47,H =50.28,F =17.94,all P 〈 0.01 ）. Areas of MMP9,MPO and sCD40L under the ROC curve to predict non-calcified plaque were 0.854,0.792,0.751 respectively,when the identification threshold for non-calcified plaque were 510.13,537.82,7.05 μg/L respectively,the diagnostic sensitivity was 80%,80%,80% respectively,and specificity was 80%,67% and 55% respectively.Conclusion The serum MMP9,MPO and sCD40L levels can help to determine the character of coronary plaque.

关 键 词：冠状动脉疾病 基质金属蛋白酶9 过氧化物酶 CD40配体 体层摄影术 螺旋计算机 

分 类 号：R543.3[医药卫生—心血管疾病]