血清MMP-9、MPO、CD40L及CRP对支架再狭窄及ACS患者预后及心功能预测价值

Evaluation of Diagnostic Value of Multiplex Detection of Serum MMP-9,MPO,CD40L and CRP in Coronary Heart Disease and Restenosis after Coronary Stent Implantation

目的探讨血清基质金属蛋白酶(matrix metalloproteinase-9,MMP-9)、髓过氧化物酶(myeloperoxidase,MPO)、CD40配体(CD40L)及C反应蛋白(C-reactive protein,CRP)对支架再狭窄及急性冠脉综合征(acute coronary syndrome,ACS)患者预后及心功能预测价值,为临床的诊断和治疗提供理论基础。方法选取作者医院2010-12/2012-12月收治的支架再狭窄患者30例,ACS患者30例作为研究对象,ACS患者在入院后予行支架置入术,并选择同期健康体检者30例作为对照。分别采用酶联免疫吸附法检测ACS患者术前术后,以及支架再狭窄患者血清MMP-9、MPO、CD40L及CRP的变化,评价这些检测指标的临床诊断效能。结果支架再狭窄以及ACS患者血清MMP-9、MPO、CD40L及CRP水平值显著高于正常组,差异具有统计学意义(P<0.05);再狭窄患者与ACS患者相比,差异无统计学意义(P>0.05);ACS患者予以行支架手术后与支架再狭窄组的患者各指标相比,差异具有统计学意义(P<0.05)。结论有效的联合检测血清中MMP-9、MPO、CD40L和CRP水平可提高支架再狭窄及ACS患者敏感性,对冠心病的诊断和分层有一定的应用价值,值得在临床上推广。

Objective To investigate the value of multiplex detection of serum matrix metalloproteinase-9（MMP-9）,myeloperoxidase（MPO）,CD40L and C-reactive protein（ CRP） in coronary heart disease and restenosis after coronary stent implantation and provide the better way to detect and treat acute coronary syndrome（ ACS）. Methods Thirty ACS patients and 30 patients with restenosis after coronary stent implantation from December 2010 to December 2012 in our hospital were studied. Thirty healthy cases were chosen as the control group. The value of serum MMP-9,MPO,CD40 L and CRP were detected by enzyme-linked immunosorbent assay（ ELISA）. Results The serum MMP-9,MPO,CD40 L and CRP of in patients with ACS and restenosis after coronary stent implantation was higher than those in the control group（ P〈0. 05）. Serum MMP-9,MPO,CD40 L and CRP in ACS and restenosis after coronary stent implantation groups was similar（ P〉0. 05）,and the lower in patients after coronary stent implantation than the restenosis（ P〈0. 05）. Conclusion Effective joint detection of serum MMP-9,MPO,CD40 L and CRP levels can increase the sensitivity for patients with ACS stent restenosis,and have a certain value in the diagnosis and stratification of CAS,which is worth of clinical promotion.