血清MMP-2、ICTP在急性心肌梗死中的临床价值  

Clinical role of serum ICTP and MMP-2 in acute myocardial infarction

作　　者：李莹[1] 蔡琴[1] 张卫卫[1] 王宝莉[1] 李晨辉 LI Ying;CAI Qin;ZHANG Weiwei;WANG Baoli;LI Chenhui(Department of Internal and Cardiovascular Medicine,Xi'an First Hospital,Xi'an 710002,Shaanxi,China)

机构地区：[1]西安市第一医院心内科,陕西西安710002

出　　处：《检验医学》2020年第12期1272-1276,共5页Laboratory Medicine

基　　金：陕西省重点研发计划项目(2018SF-130)。

摘　　要：目的探讨血清基质金属蛋白(MMP)-2、Ⅰ型胶原羧基末端肽(ICTP)在急性心肌梗死(AMI)中的临床价值。方法选取AMI患者120例,依据Gensini评分总分将120例AMI患者分为轻度狭窄(Gensini评分为0~7分)组(36例)、中度狭窄(Gensini评分为8~14分)组(54例)、重度狭窄(Gensini评分>14分)组(30例),以体检健康者120名作为正常对照组。收集所有对象的一般资料及实验室检测结果,包括性别、年龄、体质量指数(BMI)、吸烟史、平均动脉压(MAP)及低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)等,另收集AMI患者的高血压史、糖尿病史、Gensini评分及心肌肌钙蛋白T(cTnT)检测结果等资料。同时检测所有对象血清ICTP、MMP-2水平。结果正常对照组和AMI组之间一般资料(性别、年龄、BMI、MAP、LDL-C、TG、吸烟史)差异均无统计学意义(P>0.05)。AMI组血清ICTP、MMP-2水平均高于正常对照组(P<0.001)。受试者工作特征(ROC)曲线分析结果显示,ICTP、MMP-2诊断AMI的曲线下面积(AUC)分别为0.862、0.887,最佳临界值分别为6.4、3.6 ng/mL,敏感性分别为81.67%、85.00%,特异性分别为83.33%、83.33%。ICTP和MMP-2联合检测诊断AMI的AUC为0.978、敏感性为96.67%,特异性为95.00%。轻度狭窄组、中度狭窄组和重度狭窄组Gensini评分及血清cTnT、ICTP、MMP-2水平依次升高,各组间比较差异均有统计学意义(P<0.05),其他指标2个组之间差异均无统计学意义(P>0.05)。Pearson相关分析结果显示,血清ICTP、MMP-2与Gensini评分呈正相关(r值分别为0.862、0.858,P<0.001)。结论血清ICTP、MMP-2在AMI诊断中有一定的价值,或可作为AMI诊断及病情评估的指标。Objective To investigate the clinical role of serum matrix metalloprotein(MMP)-2 and typeⅠcollagen carboxyl terminal peptide(ICTP)in acute myocardial infarction(AMI).Methods Totally,120 patients with AMI were enrolled,and they were classified into mild group(Gensini score 0-7,36 cases),moderate group(Gensini score 8-14,54 cases),severe group(Gensini score 14,30 cases),and 120 healthy subjects were enrolled as healthy control group.The general data and laboratory determination results,including sex,age,body mass index(BMI),smoking history,mean arterial pressure(MAP),low-density lipoprotein cholesterol(LDL-C),triglyceride(TG),etc.,were collected.The hypertension history,diabetes mellitus history,Gensini score and cardiac troponin T(cTnT)results of AMI patients were collected.The serum levels of ICTP and MMP-2 were determined.Results There was no statistical significance in the general data(sex,age,BMI,MAP,LDL-C,TG and smoking history)between healthy control group and AMI group(P>0.05).The levels of serum ICTP and MMP-2 in AMI group were higher than those in healthy control group(P<0.001).The results of ROC curve analysis showed that the areas under curves(AUC)of ICTP and MMP-2 were 0.862 and 0.887,the optimal cut-off values were 6.4 and 3.6 ng/mL,the sensitivities were 81.67%and 85.00%,the specificities were 83.33%and 83.33%,respectively.The AUC of ICTP combined with MMP-2 was 0.978,the sensitivity was 96.67%,and the specificity was 95.00%.The Gensini score and serum cTnT,ICTP,MMP-2 levels of mild stenosis group,moderate stenosis group and severe stenosis group were increased in turn,and there was statistical significance among the 3 groups(P<0.05),but there was no statistical significance in the other indexes between the 2 groups(P>0.05).Pearson correlation analysis showed that serum ICTP and MMP-2 were positively correlated with Gensini score(r=0.862 and 0.858,P<0.001).Conclusions Serum ICTP and MMP-2 play roles in AMI,which can be used for AMI diagnosis and condition evaluation.

关 键 词：基质金属蛋白-2 Ⅰ型胶原羧基末端肽 急性心肌梗死 冠状动脉病变 

分 类 号：R446.1[医药卫生—诊断学]