基质金属蛋白酶12在各类型冠心病患者血清中的表达及意义

Expression and significance of matrix metalloproteinase-12 in patients with all types of coronary heart disease

目的观察不同类型冠心病(CHD)患者血清中基质金属蛋白酶12(MMP-12)水平的变化情况,探讨其与急性冠状动脉综合征(ACS)及冠状动脉狭窄程度之间的关系。方法选取CHD患者70例,包括稳定型心绞痛(SAP)组11例、不稳定型心绞痛(UAP)组44例、急性心肌梗死(AMI)组15例。按Gensini评分法评定其冠状动脉狭窄程度。另13例冠状动脉造影正常者列为对照组。用酶联免疫吸附测定(ELISA)法测定各病例血清MMP-12浓度。结果UAP组和AMI组的血清MMP-12水平,分别为(2.96±1.46)μg/L、(3.43±0.88)μg/L,均明显高于SAP组(1.95±0.41)μg/L和对照组(1.63±0.60)μg/L(P<0.01),SAP组与对照组差异无统计学意义(P>0.05),AMI组较UAP组轻度增高,但增高差异无统计学意义(P>0.05)。各组血清MMP-12水平与冠状动脉狭窄程度(Gensini评分)、冠状动脉病变支数、肌钙蛋白I、肌酸激酶同工酶、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血小板间无明显相关性。结论ACS患者血清MMP-12浓度明显升高,其水平与冠状动脉内粥样硬化斑块的稳定性密切相关,提示其有助于冠心病的危险分层,对评价冠状动脉病变严重程度及预后可能具有重要意义。

Objective To investigate the difference of peripheral serum matrix metalloproteinase-12（MMP-12） level in different subtypes of coronary heart disease（CHD） ,and to explore the relationship of MMP-12 with the severity of coronary stenosis,and the incidence of acute coronary syndrome（ACS）. Methods Seventy patients with CHD were divided into stable angina pectoris （SAP） group （ 11 patients）, unstable angina pectoris （UAP） group （44 patients）, acute myocardial infarction（AMI） group （15 patients）. The severity of coronary stenosis was graded with Gensini score. 13 subjects who underwent coronary angiography and showed no evidence of CHD served as normal controls （control） group. Peripheral serum MMP-12 level was measured by ELISA. Results Serum MMP-12 level was markedly increased in UAP group and AMI group compared with that of control group, SAP group, （2.96 ±1.46） ug/L and （3.43±0.88） ug/L vs （1.63±0.60） ug/L and （1.95±0.41） ug/L（P 〈0.01）,but no significant difference was found between SAP group and control group. In the patients with AMI , the level of MMP-12 was slightly higher than that of the patients with UAP,but no significant difference. There was no correlation between the severity of coronary stenosis and peripheral serum MMP-12 level. And there was no obvious correlation between the level of MMP-12 and the pathologic stenosis degree, the pathologic coronaries number, the level of cTnI, CK-MB, TC, TG,HDL-C, LDL-C, PLT. Conclusion The concentration of MMP-12 in ACS patients is higher obviously, and MMP-12 is related to the stability of coronary plaque; MMP-12 contributes to type the CHD and could be an important monitoring marker for CHD in clinic practice.