血清MMP-10、Hcy与非ST段抬高急性冠脉综合征严重程度的相关性  

Correlation among serum MMP-10,Hcy levels and severity of non ST elevation acute coronary syndrome

作　　者：郝恩刚 于仁亮[1] 常方圆[1] 刘跃森[1] 王涛[1] HAO En-gang;YU Ren-liang;CHANG Fang-yuan;LIU Yue-sen;WANG Tao(Second Department of Cardiology,Second People's Hospital of Liaocheng City,Liaocheng,Shandong,252600,China)

机构地区：[1]山东省聊城市第二人民医院心内二科,山东聊城252600

出　　处：《心血管康复医学杂志》2020年第2期154-158,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨血清基质金属蛋白酶10(MMP-10)、同型半胱氨酸(Hcy)与非ST段抬高急性冠脉综合征(NSTE-ACS)严重程度的相关性。方法:选择NSTE-ACS患者265例作为NSTE-ACS组,另选同期经冠脉造影检查证实为非冠心病的患者135例作为非冠心病对照组。采用多因素Logistic回归模型分析NSTE-ACS的独立危险因素;分析比较血清MMP-10、Hcy单独及联合检测诊断NSTE-ACS的效能;并分析血清MMP-10、Hcy水平与NSTE-ACS患者SYNTAX评分的相关性。结果:与非冠心病对照组比较,NSTE-ACS组BMI、吸烟史、冠心病家族史、2型糖尿病、高血压比例、LDL-C、MMP-10和Hcy水平均显著升高,HDL-C水平显著降低,P<0.05或<0.01。多因素Logistic回归分析显示,2型糖尿病、高血压、LDL-C、MMP-10和Hcy水平是NSTE-ACS的独立危险因素(OR=1.204~3.518,P<0.05或<0.01)。血清MMP-10、Hcy单独及联合检测诊断NSTE-ACS的ROC曲线下面积(AUC)分别为0.646,0.660和0.701,联合检测的诊断效能显著高于单独检测,Z=2.614,2.256,P=0.009,0.024。Pearson相关分析显示血清MMP-10、Hcy水平与NSTE-ACS患者SYNTAX评分均呈显著正相关(r=0.507,0.545,P均=0.001)。结论:血清MMP-10、Hcy是NSTE-ACS的独立危险因素,可作为辅助诊断NSTE-ACS的指标,且两者联合检测诊断效能最佳,并与NSTE-ACS患者冠脉病变严重程度呈显著正相关,临床应用价值高。Objective:To explore correlation among serum levels of metalloproteinase 10(MMP-10),homocysteine(Hcy)and severity of non ST elevation acute coronary syndrome(NSTE-ACS).Methods:A total of 265 NSTE-ACS patients were regarded as NSTE-ACS group,another 135 patients,who were proved as non-coronary heart disease(CHD)by coronary angiography simultaneously,were treated as non-CHD control group.Multivariate Logistic regression model was used to analyze independent risk factors of NSTE-ACS;diagnostic efficacy of single and combined detection of serum MMP-10 and Hcy for NSTE-ACS were analyzed;and correlation among serum MMP-10,Hcy levels and SYNTAX score was analyzed in NSTE-ACS patients.Results:Compared with non-CHD control group,there were significant rise in BMI,percentages of smoking history,CHD family history,type 2 diabetes mellitus(T2DM)and hypertension(EH),levels of LDL-C,MMP-10 and Hcy,and significant reduction in HDL-C level in NSTE-ACS group,P<0.05 or<0.01.Multivariate Logistic regression analysis indicated that T2DM,EH,levels of LDL-C,MMP-10 and Hcy were independent risk factors for NSTE-ACS(OR=1.204~3.518,P<0.05 or<0.01).Area under ROC(AUC)of single and combined detection of serum MMP-10 and Hcy diagnosing NSTE-ACS was 0.646,0.660 and 0.701 respectively,and diagnostic efficacy of combined detection was significantly higher than those of single detections,Z=2.614,2.256,P=0.009,0.024.Pearson correlation analysis indicated that serum MMP-10 and Hcy levels were significant positively correlated with SYNTAX score in NSTE-ACS patients(r=0.507,0.545,P=0.001 both).Conclusion:Serum MMP-10 and Hcy are independent risk factors of NSTE-ACS and can be used as auxiliary indexes diagnosing NSTE-ACS.Combined detection of them possesses the optimal diagnostic efficacy,and their levels are significant positively correlated with coronary disease severity in NSTE-ACS patients,which possesses high clinical application value.

关 键 词：急性冠状动脉综合征 基质金属蛋白酶10 高半胱氨酸 

分 类 号：R541.409[医药卫生—心血管疾病]