基质金属蛋白酶与老年高血压患者左心室肥厚的相关性

Relations of serum MMP-1 and MMP-9 levels with left ventricular hypertrophy in the elderly with hypertension

目的通过测定老年高血压患者血清基质金属蛋白酶1(MMP-1)、MMP-9、基质金属蛋白酶抑制剂1(TIMP-1)水平与左心室后壁厚度(LVPWT)、左心室质量指数(LVMI),探讨基质金属蛋白酶在老年人高血压心室重构中的作用。方法 60岁以上老年高血压患者89例,根据有无左心室肥厚分为两组,高血压合并左心室肥厚32例,高血压无左心室肥厚57例,另52名健康老年人设为对照组超声心动图测LVPWT及LVMI。酶联免疫吸附法(ELISA)测定血清MMP-1、TIMP-1水平。结果健康对照组、高血压无左心室肥厚组、高血压合并左心室肥厚组LVPWT、LVMI、TIMP-1和MMP-9水平逐渐升高(均为P<0.05),而血清MMP-1水平逐渐降低(均为P<0.05)。LVMI、LVPWT与血清MMP-9、TIMP-1水平呈正相关(均为P<0.05),与MMP-1水平呈负相关(均为P<0.05)。结论 MMP-9水平与左心室质量、左心室壁厚度呈正相关,而MMP-1水平与之呈负相关。细胞外基质重构可能与老年高血压有关。

Objective To investigate the relationship of matrix metalloproteinase 1 （ MMP-1 ）, MMP-9 and tissue inhibitor of metalloproteinase-1 （ TIMP-1 ） with left ventricular hypertrophy （ LVH ） in the elderly with hypertension. Methods Eighty-nine hypertensive patients aged at least 60 years old included 32 with LVH and 57 without LVH, and 52 healthy controls were enrolled in the study. We measured the levels of serum MMP-1, MMP-9, TIMP-1, left ventricular posterior wall thickness （LVPWT） and calculated left ventrieular mass index （LVMI）. Results The levels of TIMP-1 and MMP-9, the values of LVPWT and LVMI increased progressively from the healthy control group, to the hypertension group without LVH and with LVH, while the MMP-1 levels decreased （all P 〈0. 05 ）. Serum TIMP-1 and MMP-9 were positively related to LVPWT and LVMI, and MMP-1 was negatively related to LVPWT and LVMI （ all P 〈 0. 05 ）. Conclusions In the elderly patients with hypertension, serum TIMP-1 and MMP-9 levels are positively related to and MMP-1 inversely related to LV mass and wall thickness. This may imply that extracellular matrix remodeling is involved in the development of hypertension in the elderly.