急性冠状动脉综合征患者血清基质金属蛋白酶-9水平变化及意义

Clinical significance of serum levels of matrix metalloproteinase-9 in the patients with acute coronary syndrome

目的探讨急性冠状动脉综合征(ACS)患者血清基质金属蛋白酶-9(MMP-9)水平的变化及其临床意义。方法采用酶联免疫分析(ELISA)方法,测定ACS患者、稳定型心绞痛(SAP)患者和健康对照组血清MMP-9水平的变化。结果三组MMP-9分别为(284.30±64.60)ng/ml;(169.80±35.20)ng/ml;(164.40±33.80)ng/ml。三组间比较差异有显著性意义(P<0.001),三组间两两比较,ACS组与SAP组和对照组比较差异有显著性意义(P均<0.001),而SAP组和对照组比较差异无显著性意义(P=0.922)。按SAP、不稳定型心绞痛到急性心肌梗死由轻到重的等级排列,发现MMP-9由低到高的顺序排列,MMP-9水平与冠心病事件的严重程度呈正相关(r=0.762,P<0.001)。结论冠心病患者血清MMP-9水平增高可作为ACS的一个危险信号,同时也可以作为冠心病患者危险分层的一个重要生化监测指标。

Objective To investigate the clinical significance of serum levels of matrix metalloproteinase-9（MMP-9） in the patients with acute coronary syndrome（ACS）. Methods The levels of MMP-9 in the patients with acute coronary syndrome, the patients with stable angina pectoris（SAP） and the control subjects were measured with enzyme-linked immunoassay（ELISA）. Results There was significantly difference in the levels between three groups（ P 〈 0. 0011, serum MMP-9 levels in the ACS group（284.30 ± 64.60 ng/ml） was significantly higher than that in the SAP group（ 169.80 ± 35.20 ng/ml ） （ P 〈 0.001 ） and in the control group [ 164.40 ± 33.80 ng/ml ）（ P 〈 0.001 ） ; there was no significantly difference in serum MMP-9 levels between SAP group and control group（ P= 0. 922）. From mild grade to mid grade then severe grade, the patients were arranged to the SAP group, unstable angina pectoris group and acute myocardial infarction group. With Spearman rank correlation, positive correlation was fund between serum MMP-9 levels and the severity degrees of coronary heart events（ r = 0. 762, P〈 0. 001 ）. Conclusion The elevated serum MMP-9 levels of the patients with coronary heart disease can be conducted as a dangerous signal in the onset of ACS, and as an important biochemical monitoting index in dangerous gradation of the patients with coronary heart disease.