急性冠脉综合征患者介入治疗前后血清h s CRP、MMP-9、IL-18的变化及意义

Changes of MMP-9,IL-18 and hsCRP of patients with acute coronary syndrome before and after intervention therapy

目的探讨急性冠脉综合征(ACS)患者介入治疗前后外周血血清基质金属蛋白酶-9(MMP-9)、IL-18、高敏C反应蛋白(hsCRP)的变化及临床意义。方法选择37例ACS患者,其中急性心肌梗死(AMI)12例(AMI组),不稳定型心绞痛(UAP)25例(UAP组);另选取稳定型心绞痛(SAP)患者12例作为对照组。分别于介入治疗前、介入治疗后24 h检测三组血清MMP-9、IL-18、hsCRP水平,对结果进行分析比较。结果术前AMI组、UAP组与对照组相比,IL-18、hsCRP明显升高,MMP-9明显降低(P均<0.05);术后两组IL-18、hsCRP显著升高,MMP-9显著降低,两组间比较无统计学差异(P>0.05),与对照组比较均有统计学差异(P均<0.05)。对照组上述指标手术前后无明显变化(P>0.05)。ACS患者术前hsCRP、MMP-9、IL-18水平无明显相关性(r=0.287,0.124,0.085,P均>0.05)。结论MMP-9、IL-18、hsCRP存在于不稳定斑块中,与斑块不稳定性密切相关,联合检测有助于ACS的早期防治;术后MMP-9降低可能与心肌供血改善有关。

Objective To investigate the effect of serum level of matrix metalloproteinase-9（MMP-9） , interleukin-18 （IL-18）, and high sensitive C-reactive protein （hsCRP） on the stability of coronary atherosclerotic plaque in patients before and after intervention therapy. Methods A total of 37 patients with acute coronary syndrome（ACS） were enrolled as experiment group, in which 12 patients with acute myocardial infarction（AMI） and 25 patients with unstable angina （UAP） as well as 12 patients with stable angina （SAP） studied as control. The levels of MMP-9, IL-18 and hsCRP were detected and compared. Results The levels of MMP-9, IL-18 and hsCRP in experiment group before and after intervention therapy were significantly higher than those of SAP group （ P 〈 0.05 ） ; IL-18, hsCRP in experiment group after intervention therapy were higher than before （ P 〈 0.05 ）. MMP-9 in experiment group after intervention therapy were lower than before （P 〈0.05） ; The correlation among CRP, MMP-9 and IL-18 in experiment group was no significant difference（r =0.287, 0. 124, 0.085 ;P 〉 0. 05）. Conclusions The levels of MMP-9, IL-18 and hsCRP were strongly associated with plaque unstability. They may be applied in the early prevention and management of ACS.