冠心病患者血液循环中易损斑块相关预测指标分析

Analysis of blood prediction indicators of vulnerable plaques in patients with coronary heart disease

目的探索冠心病患者血基质金属蛋白酶(MMP)、超敏C-反应蛋白(hs-CRP)、白细胞介素-6(IL-6)等指标可否作为冠心病标志物评估斑块稳定性。方法选择100例冠心病患者及16例正常对照者,在介入治疗前测定血清MMP-2、hs-CRP、IL-6及血浆MMP-9水平。结果急性心肌梗死(AMI)组和不稳定性心绞痛(UAP)组MMP-2、IL-6和MMP-9水平都显著高于稳定型心绞痛(SAP)组和对照组,差异有统计学意义(均P<0.01);SAP组MMP-9和IL-6水平高于对照组,差异有统计学意义(P<0.01)。AMI组hs-CRP显著高于对照组和SAP组(均P<0.01),UAP组也高于对照组(P<0.05),差异均有统计学意义。结论不同类型冠心病患者炎症标志物的变化提供了一种研究易损斑块的方法。冠状动脉病变严重患者炎症因子水平增高,有助于评估冠脉状动病变的严重程度。

Objective To explore whether the peripheral blood levels of matrix metalloproteinase(MMP),hyper sensitive C-reactive protein(hs-CRP)and interleukin-6(IL-6)play a pathogenic role in the development of coronary heart disease(CHD).These serum or plasma predictors will be able to evaluate the stability of plaques.Methods Serum MMP-2,hs-CRP,IL-6 and plasma MMP-9 were measured in 100 patients with CHD and 16 normal control subjects before coronary intervention.All subjects were compared with regard to dis-ease type and number of lesion vessel respectively.Results The serum levels of MMP-2,IL-6 and plasma MMP-9 in patients with acute myocardial infarction(AMI)and unstable angina pectoris(UAP)were sig-nificantly greater than those in patients with stable angina pectoris(SAP)and the control subjects(P<0.01).Patients with SAP showed higher plasma MMP-9 and serum IL-6 levels than those in the control subjects(P<0.01).Patients with AMI showed higher serum hs-CRP levels than those in the control subjects and patients with SAP(P<0.01).Patients with UAP showed higher serum hs-CRP levels than those in the control subjects(P<0.05).Conclusion Serial changes in serum MMP-2,hs-CRP,IL-6 and plasma MMP-9 in patients with different types of CHD provide an insight into research on vulnerable plaques.Patients with coronary severe stenosis showed higher blood levels of inflammatory factor.These markers might be useful in eval-uating the severity of coronary artery stenosis.