冠心病患者临床类型与细胞外基质金属蛋白酶诱导因子表达水平的关系

Expression of extracellular matrix metalloproteinase inducer in peripheral blood mononuclear cells of patients with coronary heart diseases and its clinical significance

目的：研究冠心病临床类型与细胞外基质金属蛋白酶诱导因子（EMMPRIN）的关系。方法根据临床表现和冠状动脉造影结果，179例患者分成稳定型心绞痛（SAP）35例，不稳定型心绞痛（UAP）76例，急性心肌梗死（AMI）68例，健康对照组30例。流式细胞仪检测患者外周血单个核细胞（PBMCs）表面EMMPRIN的平均荧光强度（MFI）；免疫速率法检测血清高敏C反应蛋白（hs-CRP）浓度，分析冠心病组患者EMMPRIN水平与冠状动脉造影Gensini评分的相关性。结果 PBMCs表面EMMPRIN表达在冠心病临床分型中AMI组、UAP组、SAP组明显高于对照组，差异有统计学意义（P＜0.05）。病变血管累及支数越多，其表达增加越明显，三支病变＞双支病变＞单支病变＞对照组，差异有统计学意义（P＜0.05）。相关性分析显示，PBMCs表面EMMPRIN（MFI）与血清hs-CRP浓度及冠状动脉病变Gensini评分呈正相关。结论 EMMPRIN水平与冠心病临床分型相关。

Objective To investigate the relationship of clinical classification of coronary heart diseases （CHD） with the expression of extracellular matrix metalloproteinase inducer （EMMPRIN） in peripheral blood mononuclear cells of CHD patients. Methods A total of 179 CHD cases diagnosed by coronary angiography in our department from September 2012 to May 2013 were recruited in this study. They were divided into 3 groups according to the clinical types： stable angina pectoris group （SAP, n=35）, unstable angina pectoris group （UAP, n=76）, and acute myocardial infarction group （AMI, n=68）. Another 30 healthy individuals at the same period served as normal controls. Mean fluorescence intensity （MFI） of EMMPRIN in peripheral blood mononuclear cells （PBMCs） were examined by flow cytometry. Serum level of high-sensitivity C-reactive protein （hs-CRP） was measured with immune velocity assay. The correlation of the expression of EMMPRIN was analyzed with the Gensini scores by coronary angiography. Results The expression of EMMPRIN in PBMCs was significantly higher in AMI, UAP and SAP groups than in the controls （P〈0.05）. The expression was also positively correlated with the number of involved vessels, which was increased gradually in normal controls, single-vessel, double-vessel, and triple-vessel disease groups sequentially （P〈0.05）. The EMMPRIN MFI of the PBMCs had positive correlation with the serum level of hs-CRP and Gensini scores in coronary arterial lesion. Conclusion The expression of EMMPRIN is correlated with the clinical classification of CHD.