基质金属蛋白酶-9和C反应蛋白与冠心病的相关性研究

Clinical value of combined assay of serumal matrix metalloproteinases-9 and C-reactive protein in patients with coronary artery disease

目的:探讨联合检测血清基质金属蛋白酶-9(MMP-9)、C反应蛋白(CRP)可否作为一种预测急性心血管事件发生的临床指标。方法:采用免疫散射比浊法检测CRP;酶联免疫吸附法检测MMP-9,并同时检测LDL-C水平。所有患者均行冠状动脉造影,计算冠状动脉病变积分并与CRP、MMP-9水平进行相关分析。结果:①急性冠状动脉综合征(ACS)组CRP及MMP-9水平显著高于稳定型心绞痛(SAP)组和正常组(均P<0.05),而后2组间差异无统计学意义(P>0.05);②ACS组冠状动脉狭窄病变形态积分明显高于SAP组和正常组(P<0.05),后2组间病变积分差异无统计学意义(P>0.05);③3组间LDL-C水平差异无统计学意义(P>0.05);④ACS组CRP及MMP-9水平均与冠状动脉造影狭窄病变形态积分有明显相关性(P<0.05)。⑤ACS组CRP与MMP-9间水平无明显相关性(P>0.05)。结论:冠心病患者CRP、MMP-9水平升高可能提示斑块不稳定;联合检测血清CRP、MMP-9水平,可以更有效地预测急性冠状动脉事件的发生。

Objective：To determine the value of studying study ability of AS plaque in patients with coronary artery disease by detection of serum level of C-reactive protein （CRP） combined with matrix metalloproteinases-9 （MMP-9）. Method：Using ELISA and scatter rate nephelometry, serum matrix metallproteinse9（MMP-9） and Creactiye protein（CRP） were measured in patients with acute coronary syndrome（ACS）, stable effort angina（SA） and normal control subjects. Then the level of LDL was detected. All patients underwent coronary angiography. The coronary severity scores was measured, the drugs intakes and other risk factors were investigated in all subjects. Result：①The serumal levels of CRP and MMP-9 in ACS group were significantly higher than SA and control groups（P〈0.05）. But there was no different significance between SA group and control group （P〉0.05）; ②The score of angiography morphology of coronary lesions in ACS group was significantly higher than SA and control groups （P〈0.05） But there were no different significance between SA group and control group （P〉 0.05）. ③The level of LDL was not significantly different among groups （P〉0.05）. ④The levels of CRP and MMP-9 neither in ACS group nor in SA group were correlations with the coronary severity scores （P〈0.05）. ⑤ The correlation between CRP and MMP-9 in ACS group was not significantly different （P〉0.05）. Conclusion： The increased serumal levels of CRP and MMP-9 in patients with coronary artery disease may predict the unstable conditions of plaques. It may be more beneficial to predicting the stability of AS plaque and forecasting acute cardiovascular risk by combination detection of serumal levels of CRP, MMP-9.