MMP-3基因多态性对冠状动脉介入术后再狭窄的影响

Effects of MMP-3 Gene Polymorphism in Restenosis after Percutaneous Coronary Interventions

目的探讨基质金属蛋白酶-3(MMP-3)启动子区域5A/6A基因多态性是否参与了经皮冠状动脉介入治疗(PCI)术后再狭窄发生发展过程。方法入选行PCI治疗术后复查的冠状动脉造影患者437例。收集患者复查冠状动脉造影前、后临床资料及造影结果,并留取血标本进行血清MMP-3含量以及基因多态性分析。根据MMP-3基因表型不同,分为突变组(5A/5A+5A/6A,n=136)和野生组(6A/6A,n=301)。比较2组相关资料,分析基因多态性与再狭窄的关系。结果 2组再狭窄率差异无统计学意义(42.2%vs 33.1%,P>0.05)。与突变组比较,野生组再狭窄程度([56.28±11.10)%vs(36.00±10.17)%]较高(P<0.01);2组血清MMP-3含量([13.38±3.00)μg/L v(s12.33±2.96)μg/L]差异无统计学意义(P>0.05)。携带6A等位基因患者再狭窄率要高于携带5A等位基因患者(P<0.05)。携带野生基因型是PCI术后再狭窄的危险因素。结论携带6A等位基因患者再狭窄风险性明显高于携带5A等位基因患者。

Objective To investigate the relationship between matrix metalloproteinase-3 （MMP-3） gene promoter polymorphisms 5A/6A and the restenosis after percutaneous coronary intervention （PCI）. Methods A total of 437 patients with PCI were selected in this study. Patients were divided into mutant genotype group （5A/5A±SA/6A, n=136） and wild genotype group （6A/6A, n=301） according to MMP-3 polymorphism. The angiography and clinic data were collected before and after coronary angiography in two groups of patients. The serum level MMP-3 and genotype analysis were compared be- tween two groups. Results There was no significant difference in the restenosis rate between two groups （42.2% vs 33.1%, P 〉 0.05）. The restenosis degree was significantly higher in wild genotype group than that in mutant genotype group （56.28%± 11.10% vs 36.00%± 10.17%, P 〈 0.01）. There was no significant difference in the serum level of MMP-3 between two groups （13.38μg/L ±3.00 μg/L vs 12.33 μg/L_±2196 μg/L, P 〉 0.05）. There was a higher restenosis rate in patients carrying 6A al- lele than that of patients canting 5A allele （P 〈 0.05）. Canting wild genotypes are risk factors for restenosis after PCI. Conclusion Patients carrying 6A allele have significantly higher risk of resteonsis than patients carrying 5A allele.