不同类型冠心病患者血清基质金属蛋白酶9含量及意义

Changes and roles of serum matrix metalloproteinases-9 in patients of coronary heart disease

目的观察冠心病患者血清基质金属蛋白酶9含量,探讨血清基质金属蛋白酶9在冠心病发病及病程进展中的意义。方法随机选取经冠脉造影证实的冠心病患者45例作为研究组,根据病情的严重程度分为3个亚组:稳定型心绞痛组、不稳定型心绞痛组和心肌梗死组各15例,又根据冠状动脉造影所示的冠状动脉病变程度分为3个亚组:单支病变组12例、双支病变组19例、三支或左主干病变组14例。对照组选择15例同期健康体检的健康人。血清基质金属蛋白酶9检测选用分光光度法检测。将冠心病患者组的检测结果与对照组结果进行统计学处理。结果①冠心病稳定型心绞痛、不稳定型心绞痛组和心肌梗死组3个亚组的血清基质金属蛋白酶9的浓度分别为(356.8±156.2)ng/ml、(620.3±173.1)ng/ml、(856.9±260.8)ng/ml,各组均高于正常对照组(124.2±37.6)ng/ml,且各组间均有统计学差异(P<0.05)。②单支病变组、双支病变组、三支或左主干病变组三个亚组的血清基质金属蛋白酶9浓度分别为(315.2±98.6)ng/ml、(478.8±152.2)ng/ml、(603.3±283.1)ng/ml,各组间均有统计学差异(P<0.01)。结论冠心病患者组血清基质金属蛋白酶9水平与健康人对比相对较低,并与病情严重程度和冠状动脉病变的严重程度相关。提示内源性血清基质金属蛋白酶9的增加参与了冠心病发生发展的过程。

Objective To determin levels of serum matrix metalloproteinases-9（MMP-9） in coronary heart disease patients and to investigate the roles of MMP-9 in the pathogenesis of coronary heart disease. Methods 45 coronary heart disease patients were randomly enrolled as study group and assigned into 3 subgroups according to stable angina patients and unstableangina and myocardial infarction. Control group concluded 15 health persons. And other 3 subgroup acording to the degree of pathological changes of coronary artery, as one branch changes （12cases） and two branch changes （19cases） and three branch or left main branch changes （14cases）. Serum matrix metalloproteinases-9 were determined by spectrometer. Data were processed by statistical methods which conclude T-test, F-test. Results ① The levels of MMP-9 in coronary heart disease were significantly increased than that of normal controls （356.8±156.2）ng/ml, （620.3±173.1）ng/ml, （856.9±260.8） ng/ml respectively. There were significant differences between any two of the groups （P〈0.01）. ②The concentrations of MMP-9 in the other 3 subgroups were （315.2±98.6）ng/ml, （478.8± 152.2）ng/ml, （603.3±283.1）ng/ml, respectively. There were significant differences between any two of the groups（P〈0.01）. Conclusion The concentrations of serum matrix metalloproteinases-9 were higher in coronary heart disease patients, and there were positive correlation between MMP-9 level and coronary heart disease levels. The study indicate that the short of MMP-9 take part in the pathogenesis of coronary heart disease.