心肌梗死后心脏胶原重塑与血清基质金属蛋白酶及其抑制因子的变化

Cardiac Collagen Remodeled and Changes of Matrix Metalloproteinases and Tissue Inhibitor in Patients with Myocardial Infarction

目的探讨心肌梗死(MI)后患者心脏胶原重塑与血清基质金属蛋白酶-1(MMP-1)及其抑制因子(TIMP-1)水平的变化。方法测定首次发病的MI住院患者(MI组)发病后1周、3个月、6个月的血清Ⅰ型前胶原羧基端肽(PⅠCP)和Ⅲ型前胶原(PCⅢ)、MMP-1、TIMP-1的水平,并计算PⅠCP/PCⅢ比值。以48例健康体检者作为正常对照组。结果与对照组比较,MI组PⅠCP水平在MI后3个月、6个月组明显高于对照组(P<0.05),血清PCⅢ水平在MI后各时间点均明显升高(P<0.05),MI后各时间点的PⅠCP/PCⅢ比值和血清MMP-1、TIMP-1水平均明显降低(P<0.05)。结论MI后心脏胶原合成代谢旺盛,MMP-1/TIMP-1参与MI后心脏胶原重塑的病理生理进程。

Objective To observe the changes of matrix rnetalloproteinase-1 （MMP-1）, tissue inhibitor-1 （TIMP-1）, and cardiac collagen remodeling in patients with acute myocardial infarction （AMI）. Methods 65 patients with AMI and 48 normal controls （age-, sex-matched） were enrolled in this study. Blood samples were obtained from the normal controls and the patients with AMI on the 1st week, the 3 rd month and the 6th month after AML The serum levels of MMP-1, TIMP-1, the carboxy-terminal propeptide of type I procollagen （P I CP） and precollagen Ⅲ （PCⅢ） were measured by enzyme-linked immunosorbent assay （ELISA）. Results Compared with the normal control, the serum level of P I CP on the 3 rd month and the 6th month, the level of PC Ⅲat all times, increased in AMI group. The ratio of P I CP/PCⅢ, the level of MMP-1 and TIMP-1 were significantly lower in AMI group than those in normal controls. Conclusion The results show that synthesis of myocardial collagen is upregulated after AMI, MMP-1/TIMP-1 may participate in cardiac collagen remodeling.