血清MMP-9、TIMP-1和hs-CRP在急性冠脉综合征中的表达及临床意义

Expression and the clinical sighificance of MMP-9, TIMP-1 and Hs-CRP in patients with acute coronary syndrome

目的:探讨血清基质金属蛋白酶-9(MMP-9)及其组织抑制剂-1(TIMP-1)、超敏C反应蛋白(hs-CRP)水平与急性冠脉综合征(ACS)的关系并评价其临床意义。方法:ACS组患者53例,其中急性心肌梗死(AMI)28例,不稳定型心绞痛(UA)25例;稳定型心绞痛组(SA)28例;正常对照组30例。用酶联免疫吸附法(ELISA)检测血清MMP-9、TIMP-1水平,免疫散射比浊法检测hs-CRP水平。用SPSS软件包进行统计学分析。结果:ACS组血清MMP-9、hs-CRP的水平显著高于SA组及对照组(P<0.01);TIMP-1的水平低于对照组(P<0.01),与SA组比较差异无显著性(P>0.05);MMP-9/TIMP-1的水平高于SA组(P<0.05)及对照组(P<0.01)。ACS组患者血清MMP-9、TIMP-1、MMP-9/TIMP-1与hs-CRP水平呈正相关。结论:MMP-9在ACS中的高表达及MMP-9与TIMP-1的失衡促使斑块易于破裂,与急性冠脉综合征的发生有关,可作为预测动脉粥样斑块不稳定或破裂的血清学指标。联合检测血清MMP-9、TIMP-1、MMP-9/TIMP-1与hs-CRP可能成为一种有效的判断斑块稳定性、预测急性心血管事件发生的临床指标。

Objective：To explore the effect of matrix-metalloproteinase-9 （MMP-9）, tissue inhibi-tor of metalloproteinase-1 （TIMP-1） and high sensitive C-reactive protein （hs-CRP） on acute coronary syndrome （ACS）. Methods：Fifty-three patients with acute coronary syndrome （ACS） were enrolled as ACS group, in which 28 patients with acute myocardium infarct （AMI） and 25 patients with unstable angina （UA） as well as 28 patients with stable angina （SA） were studied as SA group and 30 health volunteers served as control group. MMP-9, TIMP-lin serum were measured with ELISh, hs-CRP in serum was measured with immunoturbidimetric method. The data were analysed with SPSS software. Results： The levels of MMP-9,hs-CRP in ACS group were significantly higher than these in SA group and the control group （P〈0.01）. The level of TIMP-1 in ACS group was significantly lower than that in control group （P〈0.01）, and was no significantly difference between the SA group（P〉0.05）. The levels of MMP-9/TIMP-1 were significantly higher than that in SA group （P〈0.05） and the control group （P〈0.01）.MMP-9,TIMP-1 and MMP-9/TIMP-1 were significantly related with hs-CRP in ACS patients. Conclusions：Inflammation may be one of the risk factors which induces ACS.The high expression of MMP-9 and the imbalance of MMP-9 and TIMP-1 promote devision of plaques which involves in ACS. MMP-9, TIMP-1,MMP-9/TIMP-1 are associated with ACS patients closely and they can be new and important serum markers indicating ACS. To investigate serum MMP-9, TIMP-1, MMP-9/TIMP-1 and hs-CRP can be effective serum markers of the plaque destabilization and rypture.