肥厚型心肌病患者血浆基质金属蛋白酶-1水平与左心室流出道梗阻关系的研究

Relationship between level of plasma MMP-1 and left ventricular outflow tract obstruction in patientswith hypertrophic cardiomyopathy

目的探讨肥厚型心肌病(HCM)患者血浆基质金属蛋白酶-1(MMP-1)水平与左心室流出道梗阻的关系。方法纳入肥厚型心肌病患者72例,以基质金属蛋白酶-1(MMP-1)平均水平5.13 ng/ml为界将患者分为高MMP-1组(n=34)和低MMP-1组(n=38),分析两组患者性别、年龄、超声影像学等相关指标差异及与MMP-1相关的指标,同时比较梗阻性HCM与非梗阻性HCM患者的MMP-1水平差异。结果与低MMP-1组比较,高MMP-1组患者在年龄、氨基末端脑钠肽前体(NT-proBNP)、左心室流出道最大压差(LVOTPG)、左心室射血分数(LVEF)、左室后壁宽度(LVPWD)五项指标上存在统计学差异(P<0.05)。NT-proBNP与MMP-1呈正相关(r=0.521,P=0.025),LVOTPG与MMP-1呈正相关(r=0.596,P=0.018),LVEF与MMP-1呈负相关(r=-0.471,P=0.031),LVPWD与MMP-1无显著相关性。梗阻性HCM患者较非梗阻性HCM患者的MMP-1水平显著升高,差异有统计学意义(P<0.05)。结论 MMP-1与NT-proBNP、LVOTPG、LVEF有相关性,在肥厚型心肌病患者左心室流出道梗阻的判断中有一定的价值。

Objective To discuss the relationship between level of plasma matrix metalloproteinase-1 （MMP-1） and left ventricular outflow tract obstruction in patients with hypertrophic cardiomyopathy （HCM）. Methods HCM patients （n=72） were divided into high MMP-1 group （n=34） and low MMP-1 group （n=38） taken average level of MMP-1 （5.13 ng/mL） as a bound. The difference in indexes of sex, age and ultrasound image, and correlation between these indexes and MMP-1 were analyzed. The level of MMP-1 was compared between the patients with obstructive HCM and those with non-obstructive HCM. Results The comparison between low MMP-1 group and high MMP-1 group showed that there were statistical differences in age, NT-proBNP, LVOTPG, LVEF and LVPWD （P〈0.05）. NT-proBNP was positively correlated to MMP-1 （r=0.521, P=0.025）, LVOTPG was positively correlated to MMP-1 （r=0.596, P=0.018）, LVEF was negatively correlated to MMP-1 （r=-0.471, P=0.031）, and LVPWD was not correlated to MMP-1. The relation between age and MMP-1 showed a nonlinear correlation. The level of MMP-1 increased significantly in the patients with obstructive HCM compared with those with non-obstructive HCM （P〈0.05）. Conclusion MMP-1 is correlated to NT-proBNP, LVOTPG and LVEF, which is valued to the diagnosis of left ventricular outflow tract obstruction in HCM patients.