基质金属蛋白酶-9和内皮祖细胞在心脏移植术患者中表达的相关性及临床意义

Expression and clinical significance of matrix metalloproteinase-9 and endothelial cells in patients undergoing cardiac transplantation

目的:探讨基质金属蛋白酶-9(MMP-9)和内皮祖细胞(EPCs)在心脏移植术患者中表达的相关性及临床意义。方法:选取2012年1月至2016年1月在本院接受心脏移植手术的120例患者作为病例组。同期在本院体检中心按年龄、性别匹配抽取120例健康人群作为对照。采用酶联免疫吸附法(ELISA)检测血浆MMP-9水平,采用流式细胞术检测EPCs,对比分析两组MMP-9和EPCs差异及相关性。结果:病例组心脏移植术后血浆MMP-9和EPCs较移植前明显升高,差异有统计学意义(P﹤0.05),病例组心脏移植前后MMP-9和EPCs均明显高于对照组,差异有统计学意义(P﹤0.05);心脏移植术发生并发症病例组血浆MMP-9和EPCs分别为(128.46±7.32)mg/L、(166.84±14.82)个,明显高于正常病例组的(94.25±7.14)mg/L、(134.68±13.68)个(P﹤0.05);心脏移植术死亡病例组血浆MMP-9和EPCs分别为(137.36±8.13)mg/L、(168.24±14.62)个,明显高于正常病例组的(92.85±7.06)mg/L、(98.41±13.24)个(P﹤0.05);心脏移植术患者血浆MMP-9表达与EPCs表达呈正相关(r=0.686,P=0.000)。结论:血浆MMP-9和EPCs水平与心脏移植术后心脏移植物血管病变早期病理变化有密切关系,通过监测血浆MMP-9和EPCs动态变化可能有助于尽早发现心脏移植术后心脏移植物血管病变倾向的高危患者,并及时调整治疗方案。

AIM： To investigate the expression and clinical significance of matrix metalloproteinase-9（ MMP-9） and endothelial cell（ EPCs） in patients undergoing cardiac transplantation. METHODS：From January 2012 to January 2016,120 patients undergoing cardiac transplantation in our hospital were selected as the study group. At the same time,120 healthy people were selected as the control group according to age and sex matching. The level of MMP-9 in plasma was detected by enzyme linked immunosorbent assay（ ELISA）. The level of EPCs was detected by Flow cytometry,the difference and correlation between MMP-9 and EPCs in two groups were compared and analyzed. RESULTS： The levels of MMP-9 and EPCs in plasma of patients after heart transplantation were significantly increased,compared with those before transplantation, the difference was statistically significant（ P〈0. 05）.The levels of MMP-9 and EPCs before and after heart transplantation in the study group were significantly higher than those in the control group,the difference was statistically significant（ P 0. 05）.The levels of MMP-9 and EPCs in the patients plasma with heart transplantation complication were（ 128. 46 ± 7. 32） mg/L and 166. 84 ± 14. 82,which were significantly higher than those in the normal group（ 94. 25 ± 7. 14） mg/L and 134. 68 ±13. 68（ P ﹤0. 05）. The levels of MMP-9 and EPCs in the patients plasma with heart transplantation death cases were（ 137. 36 ± 8. 13） mg/L and168. 24 ± 14. 62, which were significantly higher than those in the survival cases（ 92. 85 ± 7. 06）mg/L and 98. 41 ± 13. 24（ P ﹤0. 05）. The expression of MMP-9 was positively correlated with the expression of EPCs（ r = 0. 686,P = 0. 000） in patients undergoing heart transplantation. CONCLUSION： The levels of MMP-9 and EPCs in plasma is closely related to early pathologic changes of allograft vasculopathy after heart transplantation; monitoring the dynamic changes of plasma MMP-9 and EPCs of high-risk patients may contribute to observe the early after cardiac allograft vasculopathy tendency after heart transplantation,and timely adjust the treatment plan.