动态检测基质金属蛋白酶在预测经皮冠脉介入术后支架内再狭窄的意义

Significance of dynamic detection of matrix metalloproteinase in prediction of in-stent restenosis after percutaneous coronary intervention

目的 探讨基质金属蛋白酶MMP-1、MMP-9与经皮冠脉介入术后再狭窄的关系.方法 回顾性分析165例经皮冠脉介入（PCI）术后患者,其中造影检查证实无再狭窄组140例,共183个病变;再狭窄组25例,共30个病变;比较两组外弹力膜横截面积、最小管腔面积、内膜增生面积、斑块面积;术前及术后均行基质金属蛋白酶检测,分析PCI术前术后两组MMP-1、MMP-9的变化.结果 再狭窄组有更大的内膜增生面积、斑块面积及更少的最小管腔面积;两组患者术前及术后的MMP-1水平无明显差异,无再狭窄组术前术后MMP-9水平差异无统计学意义（P 〉 0.05）,而再狭窄组术后MMP-9明显升高（P 〈 0.05）.结论 经皮冠脉介入术后支架内再狭窄患者MMP-9水平升高,与再狭窄有明显相关性.

Objective To explore the relationships between matrix metalloproteinase （MMP-1 ＆ MMP-9） and resteno- sis after percutaneous coronary intervention （PCI）. Methods One hundred and sixty-five cases after PCI were retro- spectively analyzed and divided into non-restenosis group （n=140） with total 183 lesions and restenosis group （n=25） including 30 lesions after confirmation of contrast examination. The external elastic membrane area （EEMA）, minimal lumen area （MLA）, intimal hyperplasia area （IHA）, and plaque area （PA） were tection was implemented before and after surgery in order to analyze changes compared in the two groups. MMP de- of MMP-1 and MMP-9 in both groups. Results In the restenosis group, the IHA and PA were larger, while MLA was less compared with those in the non- restenosis group. The levels of MMP-1 before and after operation didn＇t display significant differences in both groups as well as the levels of MMP-9 in the non-restenosis group （P 〉 0.05）. However, the postoperative MMP-9 level in restenosis group increased remarkably （P 〈 0.05）. Conclusion The rise of MMP-9 level after PCI is highly correlated with restenosis.