基质金属蛋白酶与冠状动脉斑块稳定性相关研究

Relationship Between Matrix Metalloproteinase and Coronary Plaque Stability

目的 :探讨基质金属蛋白酶 1(MMP 1)、基质金属蛋白酶抑制剂 1(TIMP 1)、TIMP 1/MMP 1与冠状动脉 (冠脉 )粥样硬化斑块稳定性的相关性。方法 :以冠脉血管内超声检出冠脉粥样硬化斑块的软硬特性 ,将急性冠脉综合征患者分为不稳定斑块组 (n =2 2 )和稳定斑块组 (n =12 )。测定两组间血浆MMP 1、TIMP 1浓度 ,并与冠脉血管内超声测定的斑块大小、斑块纤维帽厚度、脂核或无回声带大小、脂核或无回声带与斑块比及面积狭窄率进行相关性分析。结果 :在冠状静脉窦血和外周血中 ,不稳定斑块组MMP 1浓度明显大于稳定斑块组 (P <0 0 1) ,TIMP 1/MMP 1明显小于稳定斑块组 (P <0 0 0 1) ,有非常显著性差异。血浆MMP 1浓度与纤维帽厚度呈负相关 ,与脂核或无回声带面积、脂核与斑块比和面积狭窄率呈正相关 ,与斑块大小无关。TIMP 1/MMP 1与纤维帽厚度、面积狭窄率呈正相关 ,与脂核或无回声带面积、脂核与斑块比呈负相关。结论 :MMP 1和TIMP 1/MMP 1与冠脉斑块不稳定性呈密切相关 ,可望作为冠脉斑块不稳定性的参考指标。

Objective: To investigate the correlation between matrix metalloproteinase-1 (MMP-1),tissue inhibitors of metalloproteinase-1(TIMP-1),TIMP-1/MMP-1 and coronary atherosclerotic plaque stability. Methods: Twenty-two patients with acute coronary syndrome and soft plaque by itravascular ultrasound (IVUS) were categorized as vulnerable plaque group and twelve patients with no acute coronary syndrome but hard plaque as stable plaque group.The plasma levels of MMP-1 and TIMP-1 were determined and their correlation with IVUS plaque characteristics was analaysed. Results: The plasma level of MMP-1 was much higher in vulnerable plaque group than in stable plaque group (p<0.01),and the ratio of TIMP-1/MMP-1 in vulnerable plaque group was far lower than that in stable plaque group (p<0.001).Plasma MMP-1 content was negatively correlated with plaque fibrous cap thickness, and positively with emptied plaque or lipid core size, lipid to plaque ratio and area stenosis.The ratio of TIMP-1/MMP-1 was positively correlated with plaque fibrous cap thickness, plaque area, area stenosis, and negatively with emptied plaque or lipid core size, lipid to plaque ratio. Conclusion: MMP-1 and TIMP-1/MMP-1 can be used as reference indices for the identification of plaque unstability.