基质金属蛋白酶-1、9在小儿先天性心脏病肺血管重构中的作用

Roles of Serum Matrix Metalloproteinase-1,-9 in Pulmonary Vascular Reconstitution of Patients with Congenital Heart Disease

目的探讨先天性心脏病患儿血清中的基质金属蛋白酶（MMP-1、MMP-9）在肺血管重构中的作用。方法81例左向右分流型先心病患儿按治疗前肺动脉收缩压（SPAP）分为4组：非肺动脉高压组16例（SPAP〈30mmHg）、轻度肺动脉高压组21例（SPAP30—39mmHg）、中度肺动脉高压组211例（SPAP40-69mmHg）和重度肺动脉高压组23例（SPAP≥70mmHg）。选择21例健康儿童作为对照组，用酶联免疫吸附法（ELISA）检测血清MMP-1和MMP-9含量。结果与对照组比较，先心病各组MMP-1、MMP-9均显著增高（P〈0．05）。结论左向右分流型先心病患儿血清MMP-1、MMP-9含量显著增高，MMP-1、MMP-9可能协同参与肺血管重构，MMP-1对触发肺血管重构可能起着更积极的作用。

Objective To explore the roles of serum matrix metalloproteinase （MMP-1 ,MMP-9） in pulmonary vascular reconstitution of patients with congenital heart dlsease. Methods According to the pulmonary arterial systolic pressure （SPAP）,81 patients with congenital heart disease were divided into four groups：no pulmonary hypertension （PH） group （ 16 patients,SPAP 〈 30 mmHg）,light PH group （21 patients, SPAP30 -39 mmHg）,mederate PH group （21 patients,SPAP 40-69 mmHg） and heavy PH group （23 patients,SPAP≥70 mmHg）. The concentrations of serum MMP-1 ,MMP-9 were rneasured with ELISA. Results The concentrations of serum MMP-1 were increased remarkably in all groups of patients, compared with the control group. And the levels of MMP-9 were also significantly advanced in all groups with PH. Condusion （1） The concentrations of serum MMP-1, MMP-9 in patients with congenital heart disease of left-to-fight shunt type obviously increase. They may synergistically contribute to the process of pulmonary vascular reconsfitufion and MMP-1 may be more positive in initiating pulmonary vascular reconstitution than MMP-9 does.