急性心肌梗死患者经皮冠状动脉介入治疗后血清基质金属蛋白酶-9和肿瘤坏死因子-α的变化  

Time-dependent changes of serum concentrations of matrix metalloproteinase-9 and tumor necrosisfactor-eL in patients with acute myocardial infarction after percutaneous coronary intervention

作　　者：陈畅[1] 臧彬[2] 

机构地区：[1]大连医科大学附属第一医院急诊科,辽宁大连116011 [2]中国医科大学附属第二医院重症医学科,辽宁沈阳110004

出　　处：《中国中西医结合急救杂志》2012年第4期244-247,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

摘　　要：目的探讨急性心肌梗死（AMI）患者急诊经皮冠状动脉介入治疗（PCI）术后血清基质金属蛋白酶-9（MMP-9）和肿瘤坏死因子-α（TNF-α）的变化及其相关性。方法选择AMI患者87例，在急诊PCI术后根据冠状动脉（冠脉）造影结果分为1支、2支病变组和3支病变组，以同期30例健康体检者作为健康对照组。于PCI术前及术后1、3、7d采集清晨空腹静脉血，用双抗体夹心酶联免疫吸附试验（ELISA）测定血清MMP-9和TNF-α水平，并分析二者的相关性。结果急诊PCI术前AMI患者血清MMP-9和TNF-α水平均高于健康对照组（均P〈0．01）；PCI术前3支病变组血清MMP-9水平显著高于1支、2支病变组（P〈0．05）。AMI患者急诊PCI术后血清MMP-9和TNF-α水平均呈逐渐回落趋势，MMP-9的变化大于TNF-α；AMI患者PCI术前和术后1d血清MMP-9水平与TNF-α水平呈显著正相关（r1=0．599，P1=0．000；r2=0．492，P2=0．004）；术后3d和7d二者血清水平无相关性（r3=0．138，B=0．509；r4=0．196，P4=0．421）。结论AMI患者通过PCI术治疗获益可能与急诊PCI术后血清MMP-9和TNF-α水平降低有关，二者可能共同参与AMI发生的早期病理生理过程。Objective To investigatechanges of the serum concentrations of matrix metalloproteinase-9 （MMP-9） and tumor necrosis factor-α （TNF--α ） in patients with acute myocardial infarction （AMI） after percutaneous coronary intervention （PCI） and the correlation between MMP-9 and TNF-α. Methods Eighty-seven consecutive patients with AMI admitted for PCI within 12 hours of symptom onset were divided into three groups ： 1-vessel AMI, 2-vessel AMI and 3-vessel AMI group according to angiographical assessment of coronary arteries, and 30 healthy cases were assigned as the healthy control group. The serum concentrations of MMP-9 and TNF-αwere tested before and 1, 3, and 7 days after PCI treatment in the patients and controls by enzyme-linked immunosorbent assay（ELISA）, and the relevance between MMP-9 and TNF-α was analyzed. Results The serum concentrations of MMP-9 and TNF-α were elevated significantly before PCI treatment in AMI patients as compared to the healthy control group （all P〈0.01 ）, and serum MMP-9 concentration before PCI treatment was significantly higher in the patients with 3-vessel AMI group than in those with 1- or 2-vessel AMI groups （P〈0.05）. Serum MMP-9 and TNF-α concentrations in the AMI patients showed a gradual decrease after PCI treatment, and the change of serum MMP-9 concentration was more significant than that of serum TNF-α concentration. Serum MMP-9 concentrations before PCI treatment and after 1 day were positively correlated with serum TNF-α concentrations （rl = 0.599, P1 = 0.000 ; r2 = 0.492, P2 = 0.004）, but there was no relevance between MMP-9 and TNF-α after PCI treatment for 3 days and 7 days （r3=0.138, P3= 0.509 ; r4=0.196, P4=0.421）. Conclusion The rapid recovery of AMI patients having undergone PCI emergent treatment may associate with the decrease of serum MMP-9 and TNF-α concentrations, and MMP-9 and TNF-α may jointly be involved in the early pathophysiologic process of AMI.

关 键 词：急性心肌梗死 基质金属蛋白酶-9 肿瘤坏死因子-Α 经皮冠状动脉介入治疗 

分 类 号：R542.22[医药卫生—心血管疾病] R256.2[医药卫生—内科学]