急性心肌梗死患者基质金属蛋白酶-9水平与急诊介入术中无复流的关系研究  

Association of Matrix Metalloproteases-9 and C-reactive Protein Levels with No-reflow after Primary Pecutaneous Coronary Intervention in Patients with Acute Myocardial Infarction

作　　者：王环[1] 赵凤琴[1] 

机构地区：[1]辽宁医学院第三附属医院心内科,辽宁省锦州市121000

出　　处：《中国全科医学》2013年第5期508-510,共3页Chinese General Practice

摘　　要：目的探讨急性ST段抬高型心肌梗死患者行急诊经皮冠状动脉介入治疗(PCI)术前血基质金属蛋白酶-9(MMP-9)及C反应蛋白(CRP)水平与无复流的关系。方法将发病12 h内接受急诊PCI的急性ST段抬高型心肌梗死患者83例分为无复流组(n=17)和正常血流组(n=66)。采用双抗体夹心酶联免疫吸附试验测定血浆MMP-9的水平,采用免疫散射比浊法检测CRP、肌钙蛋白I(cTnI)水平。结果无复流组患者血浆MMP-9、CRP、cTnI水平均高于正常血流组,差异有统计学意义(P<0.05);无复流组MMP-9和cTnI水平呈正相关关系(r=0.290,P=0.008);无复流组患者MMP-9、cTnI和CRP水平无相关性(r=0.018、0.139,P=0.872)。结论 PCI前血浆MMP-9、CRP及cTnI水平对预测PCI术中无复流的发生有临床价值,可在术前有效识别和筛选出高危患者,降低无复流的发生率,提高临床治愈率。Objective To explore the association of matrix metalloproteases - 9 （ MMP - 9 ） and C - reactive protein （CRP） levels with no - flow after primary pecntaneous coronary intervention （PCI） in patients with ST segment elevation acute myocardial infarction. Methods A total of 83 patients with ST segment elevation acute myocardial infarction were enrolled in this study. All patients received PCI within 12 hours after disease onset. They were divided into no - reflow group （ n = 17 ） and normal blood flow group （ n = 66 ） after the intervention. The plasma MMP - 9 were measured using double antibody sandwich en- zyme -linked immunosorbent assay, and the CRP and troponin I （cTnI） were measured using immuno - scatter turbidmetry. Results The no - reflow group had significantly higher plasma levels of MMP, CRP, and eTnI than the normal blood flow group （ P 〈 0.05 ）. In the no - flow group, MMP - 9 was positively correlated with and eTnI （ r = 0. 290, P = 0. 008 ） while no corre- lation was found between MMP -9 and CRP （r =0. 018, P =0. 872） and between CRP and cTnI （r =0. 139, P =0. 209）. Conclusion Plasma MMP - 9, CRP and cTnI levels before PCI may be predictive for the occurrence of no - reflow. Patients at high risk of no - relow should be carefully identified and selected to lower the incidence of no - reflow and increase the clinical cure rate.

关 键 词：急性ST段抬高型心肌梗死 血管成形术 经腔 经皮冠状动脉 基质金属蛋白酶-9 无复流现象 C-反应蛋白 

分 类 号：R542.22[医药卫生—心血管疾病]