冠心病患者高敏C反应蛋白、基质金属蛋白酶-9及妊娠相关血浆蛋白A水平及临床意义

Levels and clinical significance of high sensitive C-reactive protein,matrix metalloproteinase and pregnancy-associated plasma protein-A in patients with coronary heart disease

目的探讨不同类型冠心病患者外周静脉及冠状动脉血高敏C反应蛋白(hs-CRP)、基质金属蛋白酶-9(MMP-9)和妊娠相关血浆蛋白A(PAPP-A)水平及及临床意义。方法连续入选150例冠心病(CHD)患者,其中急性心肌梗死组(AMI组)40例、不稳定型心绞痛组(UAP组)60例、稳定型心绞痛组(SAP组)50例,另外选择冠状动脉造影正常的受试者20例作为对照组。分别检测受试者外周静脉及冠状动脉血hs-CRP、MMP-9及PAPP-A水平,进行组间及不同外周静脉及冠状动脉血间指标差异比较。结果 UAP组、AMI组外周静脉血及冠状动脉血hs-CRP、MMP-9和PAPP-A水平显著增高,与对照组及SAP组比较,均有明显统计学差异(P<0.05～0.01);AMI组与UAP组比较,血hs-CRP、MMP-9和PAPP-A水平亦有显著统计学差异(P<0.01);但SAP组与对照组比较,血hs-CRP、MMP-9和PAPP-A水平无统计学差异(P>0.05)。外周静脉血及冠状动脉血hs-CRP、MMP-9、PAPP-A相互间呈显著正相关性(P均<0.05)。结论 hs-CRP、MMP-9及PAPP-A与急性冠脉综合征(ACS)发病密切相关,其测定有助于ACS的早期诊治。

Objective To discuss the levels and clinical significance of high-sensitivity C-reactive protein （hs-CRP） ,matrix metalloproteinase （MMP） and pregnancy-associated plasma protein-A （PAPP-A） in peripheral vein and coronary artery in patients with different types of coronary heart disease （CHD）. Methods The patients with CHD （n = 150） were selected continuously and there were 40 cases in acute myocardial infarction group （AMI group）, 60 in unstable angina pectoris group （UAP group） and 50 in stable angina pectoris group （SAP group）. Other 20 ca- ses with normal results of coronary angiography （CAG） were selected as control group. The levels of hs-CRP, MMP and PAPP-A in peripheral vein and coronary artery were respectively detected, and the differences were compared among all groups and different blood indexes of peripheral vein and coronary artery. Results The levels of hs-CRP, MMP and PAPP-A in peripheral vein and coronary artery increased significantly in UAP group and AMI group compared with con- trol group and SAP group （ P 〈 0.05 - P 〈 0.01 ）. The comparison between AMI group and UAP group showed signifi- cantly statistical difference in the levels of hs-CRP, MMP and PAPP-A （P 〈0.01 ） ,while the comparison between SAP group and control group showed no statistical difference （ P 〉 0.05 ）. The levels of hs-CRP, MMP and PAPP-A in pe- ripheral vein and coronary artery showed significantly correlation （ all P 〈 0.05 ）. Conclusion The levels of hs-CRP, MMP and PAPP-A are closely related to acute coronary syndrome （ACS） , and the detection of which is helpful to the early diagnosis and treatment of ACS.