急性心肌梗死患者血清MMP-9、TIMP-1、hs-CRP变化及其与心室重构的关系

Serum MMP-9,TIMP-1,hs-CRP changes and their relations with ventricular remodeling in acute myocardial infarction patients

目的探讨急性心肌梗死(AMI)患者血清基质金属蛋白酶-9(MMP-9)、金属蛋白酶组织抑制因子-1(TIMP-1)以及超敏C反应蛋白(hs-CRP)的变化与AMI后近期左心室重构(LVRM)和功能的关系。方法临床纳入71例首次AMI患者,其中31例患者(A组)在发病后12 h内给予经皮冠状动脉介入治疗(PCI),20例患者(B组)给予发病后7 d内的延迟PCI,20例患者(C组)不进行PCI,给予常规内科治疗,同时选取17例健康者(D组)作为对照组。检测各组患者血清MMP-9、TIMP-1以及hs-CRP的变化。使用超声心电图检测舒张末期容积指数(EDVI)、收缩末期容积指数(ESVI)、射血分数(EF)和室壁运动指数(WNSI)。结果 A组EDVI、ESVI、EFA明显好于B、C组,B组好于C组(P<0.05)。MMP-9、TIMP-1、hs-CRP B组好于A、C组(P<0.05)。结论 AMI后早期血清MMP-9浓度即升高,LVRM过程中MMP-9浓度与EDVI、呈正相关,与EF呈负相关。

[ Objective ] To study the changes of serum matrix metalloproteinase-9（MMP-9） and tissue inhibitor of metalloproteinase factor -1 （TIMP-1） and high-sensitivity C-reactive protein（hsCRP） in acute myocardial infarction （AMI） patients and their relations with left ventricular remodeling. [Method] The study included 71 patients with first AMI, that 31 patients （group A） were given percutaneous coronary interventional therapy （PCI） within 12 hours after acute myocardial infarction, 20 patients （group B） weregiven the delayed PCI within 7 days after acute myocar- dial infarction, 20 patients （group C） without PCI, treated with conventional medical treatment, while 17 healthy sub- jects （group D） as a control group . Each group was detected in patients with serum MMP-9, TIMP-1 and hs-CRP changes. Echocardiography was used to detect diastolic volume index （EDVI）, systolic volume index （ESVI）, ejection fraction（EF） and wall motion index （WNSI）. [Results] EDVI, ESVI, EFA in group A were significantly better than group B, group C, and group B was better than group C （P 〈0.05）. MMP-9, TIMP-1, hs-CRP in group B were better than group A, group C （P 〈0.05）. [Conclusion] Serum MMP-9 concentration increased early after AMI, MMP-9 concentration was positively correlated with the EDVI, and was negatively correlated with the EF during LVRM.