金属基质蛋白酶9预测早发急性冠脉综合征患者冠状动脉病变程度的临床研究  

Relationship between serum matrix metalloproteinase-9(MMP9) level and severity of coronary lesions in premature acute coronary syndrome

作　　者：朱嘉俊[1] 徐锐[1] 杨毅宁[2] 马依彤[1] 李晓梅[2] 向阳[2] 陈邦党[1] 刘芬[1] 赵倩[2] 

机构地区：[1]新疆医科大学第一附属医院冠心病重点实验室,新疆乌鲁木齐830054 [2]新疆医科大学第一附属医院冠心病科,新疆乌鲁木齐830054

出　　处：《中国现代医学杂志》2015年第16期32-36,共5页China Journal of Modern Medicine

基　　金：国家自然科学基金(No.81060025);教育部新世纪优秀人才支撑计划(No:NCET-11-1074)

摘　　要：目的研究早发急性冠脉综合征（PACS）患者金属基质蛋白酶9（MMP-9）与能够反映冠脉病变严重程度Gensini积分的相关性。方法选择2013年1—12月在该院入院治疗的PACS患者（男性≤55岁，女性≤65岁）131例，计算病例组Gensini积分，以中位数（40分）为界值分为高Gensini组（≥40分）67例，低Gensini组（〈40分）64例。选择152例健康志愿者为对照组。用酶联免疫吸附试验（ELISA）~,4量血浆MMP-9水平，比较各组MMP一9是否具有差异。结果病例组MMP一9水平显著高于对照组『（1．46±0．37）vs（1．07±0．48）mg／L，P〈0．001]；高Gensini组MMP-9浓度高于低Gensini组[（1．63±0．30）vs（1．29±0．37）mg／L，P〈0．0011；ROC曲线计算MMP-9判断高Gensini组的最佳切点值为1．47，其敏感度、特异度分别为76％和64％；吸烟、BMI和MMP-9（〉1．47mg／L）是PACS患者发生高Gensini的独立危险因素（o良=3．123，95％CI：1．215~6．798。P〈0．001）。结论金属基质蛋白酶9与PACS患者冠脉病变严重程度具有相关性，对其早期危险分层有一定的参考价值。[ Objective ] To investigate the relationship between serum matrix metalloproteinase-9 （MMP-9） level and severity of coronary lesions in Premature Acute Coronary Syndrome （PACS）. [Methods] A total of 131 PACS patients （man＇s age ≤55 years, woman＇s age ~〈65 years） admitted into our hospital between January 2013 and De- cember 2013 were recruited, and the case group were also divided into two groups according to the median of the modified Gensini score （P50 = 40） preoperatively. The two groups were severe coronary artery disease group （Gensini score≥40, n = 67） and moderate coronary artery disease group （Gensini score〈40, n = 64）. The control group in- cluded 152 subjects of healthy volunteers. The levels of plasma MMP-9 in venous blood were detected by enzyme- linked immunosorbent assay （ELISA）. [ Results ] The plasma MMP-9 concentration was significantly higher in case group than in control group [（1.46±0.37） vs （1.07±0.48） mg/L, P 〈 0.001]. The plasma MMP-9 concentration in- creased gradually with the increase of extent of coronary lesions. The serum MMP-9 level in severe coronary artery disease group was higher than that in moderate coronary artery disease [（1.63-＋0.30） vs （1.29±0.37） mg/L, P 〈 0.001]. In ROC analysis, smoking, BMI, MMP-9 （〉1.47 mg/L） predicted severe coronary artery disease with 76% sensitivity and 64% specificity. Also, MMP-9 （〉1.47 rag/L） was an independent predictor of severe coronary artery disease de- velopment （OR=3.123, 95%CI： 1.215~6.798, P〈0.001）. [ Conclusions] MMP-9 concentration can be a reliable pre- dictive index for severity of coronary lesions in PACS, and this parameter could provide useful information for the early risk evaluation on these patients.

关 键 词：冠状动脉粥样硬化性心脏病 早发 金属基质蛋白酶9 冠脉病变程度 

分 类 号：R541.4[医药卫生—心血管疾病]