血清MMP-8/TIMP-1水平与ACS患者心功能及预后的相关性分析

Relationships of serum MMP-8/TIMP-1 ratio with cardiac function and prognosis of patients with acute coronary syndrome

目的探讨血清基质金属蛋白酶-8(MMP-8)/基质金属蛋白酶抑制剂-1(TIMP-1)与急性冠状动脉综合征(ACS)心功能及其预后的相关性。方法选取行冠状动脉造影检查者160例,其中105例确诊ACS患者作为ACS组,其余55例健康者作为对照组。比较两组血清MMP-8、TIMP-1及左室射血分数(LVEF)。ACS组行常规治疗,PCI术后7 d再次检测血清MMP-8、TIMP-1、MMP-8/TIMP-1及LVEF,出院后随访≥1年,统计ACS组支架血栓发生率和生存率。分析ACS患者血清MMP-8/TIMP-1与LVEF、支架血栓发生率及1年生存率的关系及其预后的价值。结果与对照组比较,ACS组MMP-8、TIMP-1及MMP-8/TIMP-1水平升高,LVEF降低(P<0.05)。与术前比较,ACS组术后7 d MMP-8、TIMP-1及MMP-8/TIMP-1降低,LVEF升高(P <0.05)。ACS组随访1年支架血栓发生率和生存率分别为8.57%和85.71%。与存活患者比较,ACS组死亡患者围手术期MMP-8/TIMP-1升高,LVEF降低(P <0.05)。与无支架血栓患者比较,有支架血栓患者术期血清MMP-8/TIMP-1水平升高,LVEF降低(P <0.05)。ACS患者血清MMP-8/TIMP-1水平与LVEF和1年生存率均呈负相关(P<0.05),与其支架血栓发生率则呈正相关(P<0.05)。结论血清MMP-8/TIMP-1水平与ACS患者LVEF、支架血栓和生存预后均密切相关,可作为其病情和预后评估的参考指标。

Objective To investigate the relationships of serum metalloproteinase-8(MMP-8)/tissue inhibitor of metalloproteinase-1(TIMP-1)with cardiac function and prognosis of acute coronary syndrome(ACS).Methods A total of 160 cases having coronary angiography were selected.Among them,105 patients diagnosed as ACS were enrolled in the ACS group,and 55 healthy subjects were enrolled in control the group.Serum MMP-8 and TIMP-1 levels,MMP-8/TIMP-1 and LVEF of the two groups were detected.The patients in the ACS group had PCI treatment,and serum MMP-8 and TIMP-1 levels,MMP-8/TIMP-1 and LVEF were detected again 7 d after PCI.The 1-year survival rate and stent thrombosis rate of the ACS group were counted.The relationships of serum MMP-8/TIMP-1 with LVEF,stent thrombosis rate and 1-year survival rate in the ACS patients were analyzed,and the value of serum MMP-8/TIMP-1 in predicting the 1-year stent thrombosis rate and survival prognosis was analyzed.Results Compared with the control group,serum MMP-8,TIMP-1 levels and MMP-8/TIMP-1 in the ACS group were increased,while LVEF in the ACS group was decreased(P<0.05).Compared with the preoperative values,serum MMP-8,TIMP-1 levels and MMP-8/TIMP-1 were decreased,while LVEF was increased 7 days after PCI in the ACS group(P<0.05).The 1-year follow-up stent thrombosis rate and survival rate in the ACS group were 8.57%and 85.71%respectively.Compared with the survivors,serum MMP-8/TIMP-1 ratio was increased,while LVEF was decreased in the dead patients of the ACS group(P<0.05).Compared with the patients without stent thrombosis,serum MMP-8/TIMP-1 ratio was increased,while LVEF was decreased in the patients with stent thrombosis in the ACS group(P<0.05).In the ACS patients,serum MMP-8/TIMP-1 ratio was negatively correlated with LVEF and 1-year survival rate(P<0.05),while positively correlated with the stent thrombosis rate(P<0.05).Conclusions Serum MMP-8/TIMP-1 ratio in ACS patients is closely related to LVEF,stent thrombosis and 1-year survival rates,which may be used as a reference index for disease severity and prognosis evaluation.