冠状动脉临界病变斑块特征与基质金属蛋白酶-9及高敏C-反应蛋白的关系

Correlation between plaque features of coronary artery borderline lesions and matrix metalloproteinase-9 or high sensitive C-reactive protein

目的探讨基质金属蛋白酶-9(MMP-9)及高敏C-反应蛋白(hs-CRP)与冠状动脉临界病变斑块特征的关系。方法选择142例临床拟诊为冠心病的患者,进行冠状动脉造影检查,对冠状动脉狭窄在50%～70%的病变行血管内超声检查,根据冠状动脉狭窄及斑块特征,分为正常对照组、稳定斑块组及不稳定斑块组。测定各组血清中MMP-9、hs-CRP浓度,分析斑块特与血清MMP-9、hs-CRP浓度的关系。结果冠状动脉临界病变中有不稳定斑块存在,不稳定斑块组血清中MMP-9、hs-CRP浓度高于稳定斑块组及正常对照组,差异有统计学意义(P<0.05),而稳定斑块组与正常对照组之间MMP-9、hs-CRP浓度差异无统计学意义。结论冠状动脉临界病变中有不稳定斑块存在,血清中MMP-9、hs-CRP浓度增高与斑块的不稳定性有关。

Objective To investigate the correlations between the concentrations of matrix metalloproteinase -9 （ MMP - 9） or high sensitive C - reactive protein （ hs - CRP）, and the plaque features of coronary artery borderline le- sions. Methods Coronary arteriography （CAG） was performed on 142 patients suspected with coronary heart disease, among whom the patients with coronary artery stenosis by 50% ~ 70% confirmed by the CAG were further investigated with intravascular ultrasound. According to the artery stenosis levels and the plaque features, the subjects were divided into the normal contrast group, （45 cases）, stable plaque group （50 cases） and unstable plaque group （47 cases）. Serum levels of MMP -9 or hs - CRP were determined. The correlations between the plaque feature and the concentrations of MMP -9 and hs - CRP were analyzed. Results Unstable plaques were observed in patients with coronary artery borderline lesions. The serum levels of MMP - 9 and hs - CRP in the unstable plaque group were significantly higher than those in the normal control group and the stable plaque group （P 〈 0. 01 ）. However, there was no significant difference in MMP- 9 or hs - CRP between the normal contrast group and the stable plaque group （ P 〉 0. 05 ）. Conclusion There are unstable plaques in the coronary artery borderline lesions. The increased MMP - 9 and hs - CRP are correlated with the unsteady state of plaque.