冠心病病人血清MMP-9与Hcy浓度变化及临床意义

CHANGES AND CLINICAL SIGNIFICANCE OF SERUM MATRIX METALLOPROTEINASE-9 AND HOMOCYSTEINE CONCENTRATION IN PATIENTS WITH CORONARY HEART DISEASE

目的探讨冠心病(CHD)病人血清基质金属蛋白酶-9(MMP-9)及同型半胱氨酸(Hcy)浓度变化及其临床意义。方法采用酶联免疫吸附(ELISA)法,测定20例急性心肌梗死(AMI)病人、20例不稳定型心绞痛(UAP)病人、20例稳定型心绞痛(SAP)病人血清MMP-9、Hcy浓度的变化,并与20例健康体检者(对照组)进行比较。结果 CHD病人血清MMP-9、Hcy浓度显著高于对照组(t′=6.73、6.40,P<0.01)。AMI组血清MMP-9、Hcy浓度明显高于UAP组、SAP组及对照组(F=35.91、40.75,q=4.95～14.14,P<0.01),UAP组高于SAP组及对照组(q=5.08～7.49,P<0.01),SAP组与对照组比较差异无统计学意义(q=0.39、1.48,P>0.05)。CHD病人血清MMP-9、Hcy浓度呈正相关(r=0.490,P<0.01),AMI、UAP组血清MMP-9、Hcy浓度ROC曲线下面积(AUCROC)均>0.90,对AMI诊断的灵敏度和特异度分别为0.95、0.95和0.90、0.95;对UAP诊断的灵敏度和特异度分别为0.85、0.95和0.85、0.80。结论血清MMP-9及Hcy浓度的变化对AMI及UAP具有较高的诊断价值,联合检测对评估CHD的病变程度及判断预后有一定价值。

Objective To explore the changes of serum matrix metalloproteinase-9(MMP-9) and homocysteine(Hcy) concentration in patients with coronary heart disease(CHD),and discuss their related clinical significance.Methods By using enzyme-linked immunosorbent assay(ELISA),the serum MMP-9 and Hcy concentration were measured in 20 patients with acute myocardial infarction(AMI),20 with unstable angina pectoris(UAP),and 20 with stable angina pectoris(SAP).The results were compared with 20 healthy controls.Results The serum concentrations of MMP-9 and Hcy in patients with CHD were much higher than that in the control(t′=6.73,6.40;P<0.01).The serum concentrations of MMP-9 and Hcy in AMI patients were significantly higher than that in the UAP,SAP patients and the controls(F=35.91,40.75;q=4.95-14.14;P<0.01),that in UAP was higher than that in SAP and the control(q=5.08-7.49,P<0.01),and the difference of that between SAP and the control was not statistically significant(q=0.39,1.48;P>0.05).There was a positive correlation between serum concentration of MMP-9 and Hcy in CHD(r=0.490,P<0.01).The areas under the ROC curve(AUCROC) of MMP-9 and Hcy were both greater than 0.90 in the AMI and UAP patients.The sensitivity and specificity of MMP-9 and Hcy were 0.95,0.95 and 0.90,0.95 in AMI while 0.85,0.95 and 0.85,0.80 in UAP.Conclusion The changes of serum MMP-9 and Hcy concentration posses a greater va-lue in the diagnosis of AMI and UAP,and combined detection of both the parameters is of some value in assessing the degree of CHD and predicting its prognosis.