急性冠脉综合征患者血浆sCD40L与血清基质金属蛋白酶水平的变化及其意义

Changes of levels of plasma sCD40L,MMP-9 and TIMP-1 in patients with acute coronary syndrome and their clinical significance

目的:观察急性冠脉综合征(ACS)患者可溶性CD40配体(sCD40L)及血清基质金属蛋白酶-9(MMP-9)、血清组织金属蛋白酶抑制物-1(TIMP-1)水平变化及其相关性。方法:采用酶联免疫吸附法测定70例冠心病患者[ACS患者35例、稳定型心绞痛(SAP)患者35例]、35例非冠心病患者(正常对照组)sCD40L、MMP-9、TIMP-1的水平。结果:与正常对照组及SAP组比较,ACS组sCD40L[(2.73±0.92)μg/ml比(3.05±0.98)μg/ml比(4.72±1.15)μg/ml]、MMP-9[(152.38±54.22)ng/ml比(341.12±69.96)ng/ml比(574.2±139.20)ng/ml]水平明显升高(P均<0.01),而TIMP-1[(415.92±13.96)ng/ml比(249.32±36.80)ng/ml比(172.20±40.10)ng/ml]水平明显降低(P<0.01);且MMP-9与sCD40L呈正相关(r=0.42,P<0.05)。结论:急性冠脉综合征患者可溶性CD40配体、血清基质金属蛋白酶-9水平升高,血清组织金属蛋白酶抑制物-1水平下降提示这两指标与粥样斑块不稳定相关,可作为判断粥样斑块不稳定的血清学指标。

Objective：To investigate changes of levels of soluble CD40 ligand（sCD40L）,serum matrix metalloproteinase-9（MMP-9） and serum tissue inhibitor of metalloproteinases-1（TIMP-1） in patients with acute coronary syndrome（ACS） and their correlation.Methods：Enzyme-linked immunosorbent assay was used to measure levels of sCD40L,MMP-9 and TIMP-1 in 70 patients with coronary heart disease（CHD） [35 ACS cases,35 cases with stable angina pectoris（SAP）] and 35 non-CHD patients（normal control group）.Results：Compared with normal control group and SAP group,the levels of sCD40L [（2.73±0.92） μg/ml vs.（3.05±0.98） μg/ml vs.（4.72±1.15） μg/ml] and MMP-9 [（152.38±54.22） ng/ml vs.（341.12±69.96） ng/ml vs.（574.2±139.20） ng/ml]significantly increased,and level of TIMP-1 [（415.92±13.96） ng/ml vs.（249.32±36.80） ng/ml vs.（172.20±40.10） ng/ml] significantly decreased in ACS group,P〈0.01 all;MMP-9 level was positively correlated with sCD40L level（r=0.42,P〈0.05）.Conclusion：Increased levels of sCD40L and serum MMP-9 and decreased serum TIMP-1 level in ACS patients may be related with instability of atheromatous plaque,and they could serve as serological indicators for instability of atheromatous plaque.