急性冠脉综合征患者血清基质金属蛋白酶-9检测

Changes of serum matrix metalloproteinase-9 in patients with acute coronary syndrome

目的:探讨急性冠脉综合征(ACS)患者中,血清基质金属蛋白酶-9(MMP-9)含量升高是否反映动脉炎症的存在;MMP-9能否预测该病的严重程度。方法:选择ACS患者67例,其中不稳定性心绞痛(UA)46例,UA患者TIMI危险积分≥3分者24例,≤2分者22例;急性心肌梗死(AMI)21例;稳定性心绞痛(SA)20例。健康对照组20例。取静脉血采用酶联免疫吸附分析法(ELISA法)检测MMP-9。比较各组间MMP-9含量差异,并将UA患者的MMP-9与TIMI危险积分进行比较。比较冠状动脉造影结果中轻、中、重度血管病变者MMP-9含量差别。结果:UA和AMI组血清MMP-9含量较SA和正常对照组显著增高(P<0.01);在UA中,MMP-9含量在TIMI危险积分≥3分者较≤2分者显著增高,MMP-9含量与TIMI危险积分呈正相关(r=0.722,P<0.001);在ACS患者中,冠脉造影中、重度血管病变者血中MMP-9含量较轻度病变者显著增高,MMP-9含量与血管病变程度呈正相关,(r=0.651,P<0.001)。结论:①在ACS发生、发展和病情恶化中,炎症起重要作用,MMP-9可作为新的炎症标志物。②MMP-9高低与病变严重程度呈正相关,可作为斑块不稳定性指标。

Aim： To investigate whether the increasing level of serum matrix metalloproteinase-9（MMP-9） in patients with acute coronary syndrome （ACS） reflects inflammation states of the arteries and whether the concentration of serum MMP-9 can predict the severity of the disease. Methods： A total of 67 patients were selected as acute coronary syndrome （ACS） group, including 46 patients with unstable angina （ UA, UA cases in ACS group were allocated into 2 subgroups according to TIMI risk score： 24 patients with score ≥3 and 22 patients with score ≤2. ） and 21 patients with acute myocardial infarction （AMI） ;20 patients with stable angina （SA） and 20 healthy individuals were used as control. The venous blood samples were taken and the concentration of MMP-9 was detected using ELISA. The concentrations of MMP-9 in different groups were compared. The concentrations of MMP-9 in patients with different lesions were compared according to the coronary angiography results. Results： The concentrations of serum MMP-9 in patients with UA and AMI were higher than those in patients with SA and normal control（ P 〈 0.01 ）;in patients with UA ,the concentrations of serum MMP-9 in those with TIMI risk score ≥ 3 was significantly higher than those with the score ≤ 2, and the concentration of serum MMP-9 was positively correlated with TIMI risk score（r = 0. 722, P 〈 0. 001 ）. According to the results of coronary angiography, the concentration of MMP-9 in ACS patients with moderate and serious lesions was significantly higher than that in patients with mild lesion. There was positive correlation between MMP-9 and degree of vessel lesion （r = 0. 651, P 〈 0. 001 ）. Conclusion ： Inflammation plays an important role in the pathogenesis and deterioration of ACS. MMP-9 can be regarded as a novel marker of inflammation;the level of MMP-9 is correlated with severity of ACS and can be regarded as an index of unstable plaque.