血清胱抑素C基质金属蛋白酶-9与不稳定型心绞痛患者曲美他嗪治疗效果的关系

Relationship between serum cystatin C and matrix metalloproteinase-9 levels and treatment response to trimetazidine in patients with unstable angina pectoris

目的分析血清胱抑素(Cys)C、基质金属蛋白酶(MMP)-9与不稳定型心绞痛(UAP)患者曲美他嗪治疗效果的关系。方法采用回顾性分析,收集信阳职业技术学院附属医院2018年10月至2020年10月收治的96例UAP患者临床资料,所有患者均在本院完成曲美他嗪2周治疗,出院后继续服药至1个月,查阅资料,记录治疗1个月时疗效,分为治疗无效组、治疗有效组。查阅资料,统计2组临床资料,记录治疗前患者血清CysC、MMP-9水平,分析血清CysC、MMP-9与UAP患者曲美他嗪治疗效果的关系。结果纳入的96例UAP患者,经曲美他嗪治疗后,治疗有效共82例,治疗无效共14例;比较2组一般资料及实验室指标后,纳入符合条件的变量作为自变量,经Logistics回归分析显示,血清CysC、MMP-9、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、肌钙蛋白Ⅰ(cTnⅠ)、乳酸脱氢酶(LDH)过表达与UAP患者曲美他嗪治疗无效有关(P<0.05)。绘制受试者工作特征(ROC)曲线图显示,血清CysC、MMP-9单独及联合预测UAP患者曲美他嗪治疗无效的曲线下面积(AUC)分别为0.813、0.818、0.861,均有一定预测价值。结论血清CysC、MMP-9过表达与UAP患者曲美他嗪治疗无效有关,治疗前检测二者水平可预测UAP治疗无效风险。

Objective To investigate the relationship between serum cystatin(Cys)C and matrix metalloproteinase(MMP)-9 levels and the treatment response to trimetazidine in patients with unstable angina pectoris(UAP).Methods This was a retrospective analysis on clinical data from 96 UAP patients admitted to the Affiliated Hospital of Xinyang Vocational and Technical College between October 2018 and October 2020.All patients completed a 2-week trimetazidine treatment in our hospital,and were continued on a 1-month medication after discharged home.The 1-month treatment response was assessed by retrieval of medical records,and then the patients were assigned to the no treatment response group and the treatment response group.From the medical records,the clinical data of the two groups were retrieved.The serum CysC and MMP-9 levels of the patients before treatment were recorded,and the relationship between serum CysC and MMP-9 level and the treatment response to trimetazidine in UAP patients was analyzed.Results Of the 96 UAP patients included in this study,82 patients responded to trimetazidine treatment while 14 did not.After preliminary comparison on the general data and laboratory indicators between the two groups,eligible variables were included as independent variables in a subsequent Logistic regression analysis,which showed that overexpression of serum CysC,MMP-9,creatine kinase(CK),creatine kinase isoenzyme(CK-MB),cardiac troponin I(cTnI)and lactate dehydrogenase(LDH)was associated with no treatment response to trimetazidine in UAP patients(P<0.05).Receiver operating characteristic(ROC)curve showed that the areas under the curve(AUC)of serum CysC and MMP-9 alone and in combination for predicting no treatment response to trimetazidine in UAP patients were 0.813,0.818,and 0.861,respectively,all of which were potentially valuable in the prediction.Conclusion Overexpression of serum CysC and MMP-9 is associated to no treatment response to trimetazidine in UAP patients.Measurement of these two indicators prior to medication may predict the risk of no treatment response in UAP.