血浆基质金属蛋白酶-9浓度与直接经皮冠状动脉介入治疗中无复流的关系  

Relation between plasma concentration of matrix metalloproteinases-9 and no-reflow in primary percutaneous coronary intervention

作　　者：解强 张鹏 黄冰生 李劲草 冯燕玲 

机构地区：[1]广州市番禺何贤纪念医院心内科,广州511400

出　　处：《岭南心血管病杂志》2013年第3期289-292,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的观察急性ST段抬高型心肌梗死(ST segment elevation acute myocardial infarction,STEAMI)患者在行直接经皮冠状动脉介入(pecutaneous coronary intervention,PCI)治疗前血浆基质金属蛋白酶-9(matrixmetalloproteases-9,MMP-9)及超敏C-反应蛋白(high sensitivity C reactive protein,hs-CRP)浓度与PCI治疗中"无复流"的关系。方法将发病12 h内接受直接PCI治疗的STEAMI患者92例分为"无复流"组(n=19)和正常血流组(n=73)。采用双抗体夹心酶联免疫吸附试验测定血浆MMP-9浓度;hs-CRP、心肌肌钙蛋白I(cardiactroponin I,CTnI)用免疫散射比浊法检测。结果 "无复流"组血浆MMP-9、hs-CRP、CTnI浓度均高于正常血流组[(73.18±16.52)ng.mL-1 vs.(55.80±13.24)ng.mL-1,P=0.001;(16.52±3.25)mg.L-1 vs.(10.34±4.56)mg.L-1,P=0.042;(9.53±4.14)ng.L-1vs.(6.48±4.29)ng.L-1,P=0.010]。"无复流"组血浆MMP-9和CTnI浓度呈正相关(r=0.290,P=0.008);血浆MMP-9浓度与hs-CRP浓度无明显相关性(r=0.018,P=0.872);hs-CRP浓度和CTnI浓度无相关性(r=0.139,P=0.209)。结论 PCI治疗前血浆MMP-9、hs-CRP及CTnI浓度在理论上对预测PCI治疗中"无复流"的发生有一定价值。Objectives To observe the relation between plasma concentration of matrix metalloproteinases-9 （MMP-9）, high-sensitivity C-reactive protein （hs-CRP） and no-reflow in patients with ST-segment elevation acute myocardial infarction （STEAMI） before primary percutaneous coronary intervention （PCI）. Methods A total of 92 patients with STEAMI treated by primary PCI in 12 hours were divided into no-reflow group（n=19） and normal blood flow group （n= 73）. Plasma concentrations of MMP-9, cardiac troponin I （CTnI） and hs-CRP were measured by double antibody sandwich enzyme-linked immunosorbent assay and immune nephelometry. Results Plasma concentrations of MMP, hs-CRP and CTnI were significantly higher in no-reflow group than those in normal blood flow group [ （73.18±16.52） ng, mL-1 vs. （55.80±13.24） ng.mL-1, P=0.001; （16.52±3.25） mg·L^-1vs. （10.34±4.56） mg.L-1,P=0.0d2; （9.53±4.14） ng·L-1 vs. （6.48±4.29） ng·L-1, P=0.010]. Plasma concentration of MMP-9 positively correlated with plasma concentration of CTnI in no-fellow group （r=0.290,P=0.008）. There was no significant correlation between plasma concentrations of MMP-9 and hs-CRP in no-reflow patients （r=0.018, P=0.872）. Plasma concentration of hs-CRP did not correlate with plasma concentration of CTnI in no-reflow patients （r=0.139,P=0.209）. Conclusions Plasma concentrations of MMP-9, hs-CRP and CTnI before PCI may predict the occurrence of no-reflow in theory.

关 键 词：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 C-反应蛋白 无复流 

分 类 号：R542.22[医药卫生—心血管疾病]