胸主动脉夹层患者血浆D-二聚体和基质金属蛋白酶-8的表达水平及其临床意义  

Levels of plasma D-dimer and matrix metalloproteinase-8 in patients with thoracic aortic dissection and their clinical significance

作　　者：王高明[1] 吴海卫[1] 徐艳辉[1] 黄海嵘[1] 苏畅[1] 申翼[1] 王常田[1] 李德闽[1] 景华[1] 

机构地区：[1]南京大学医学院临床学院(南京军区南京总医院)心胸外科,南京医学硕士研究生210002

出　　处：《医学研究生学报》2012年第2期168-171,共4页Journal of Medical Postgraduates

基　　金：南京军区医学科技创新项目课题(10MA090)

摘　　要：目的胸主动脉夹层(thoracic aortic dissection,TAD)常以胸背部疼痛为首发症状,误诊率高,是心血管疾病中最致命的急重症之一。文中分析胸主动脉夹层患者血浆D-二聚体和血浆中的基质金属蛋白酶(matrix metalloproteinase,MMP)-8水平,对其早期诊断价值进行相关分析研究。方法收集2010年3月至2011年3月68例TAD患者入院时血液标本,同期收集40例急性心肌梗死(acute myocardial infarction,AMI)患者血液标本、选取主诉胸背痛但经相关检查之后未发现有心血管疾病的正常成年人50例作为正常对照组的血液标本,检测血浆中的MMP-8、D-二聚体水平。结果 TAD患者血浆中MMP-8表达水平明显高于AMI组和正常对照组(P<0.05);TAD患者血浆D-二聚体水平在3组中最高(P<0.05)。结论 TAD患者血浆MMP-8、D-二聚体表达水平明显增高,对早期诊断有重要临床意义。Objective Thoracic aortic dissection （TAD） often starts with pain in the chest or back, and is considered as one of the most severe and acute cardiovascular diseases, with a high rate of misdiagnosis. The aim of this study was to determine the levels of D-dimer and matrix metalloproteinase （MMP）-8 in the plasma of TAD patients, and to investigate their value in the early diagnosis of TAD. Methods We collected blood samples from 68 TAD patients, 40 acute myocardial infarction （AMI） patients, and 50 healthy controls complaining of chest or back pain but with no detectable cardiovascular disease, and detected and compared their D-di- mer and MMP-8 levels. Results The TAD patients showed a significantly higher level of MMP-8 in the plasma than the AMI pa-tients and healthy controls （P 〈 O. 05 ）, while the TAD patients exhibited the highest level of D-dimer among the three groups （ P 〈 O. 05）. Conclusion The levels of D-dimer and MMP-8 are evi- dently elevated in the plasma of TAD patients, which has an important predictive value in the diagnosis of TAD.

关 键 词：胸主动脉夹层 急性心肌梗死 D-二聚体 基质金属蛋白酶-8 

分 类 号：R542.22[医药卫生—心血管疾病]