摘要
目的评价药物与择期经皮冠状动脉介入治疗(PCI)对急性心肌梗死(AMI)后基质金属蛋白酶-1(MMP-1)及其抑制物-1(TIMP-1)的影响。方法对2005年3月至2007年11月贵州省人民医院心内科的41例AMI患者在分别予强化内科药物(药物组,22例)和在此基础上行择期PCI介入(PCI组,19例)治疗。应用酶联免疫法检测AMI患者发病1周、3个月、6个月及12个月时的血清MMP-1和TIMP-1质量浓度。结果与对照组比较,药物组与PCI组各组MMP-1均显著降低;除12个月外,各时点组TIMP-1均显著降低(P<0.05)。两组组内比较,药物组12个月组TIMP-1较3个月及6个月组均显著升高(P<0.05)。两组同期各时点组比较,PCI组3个月及6个月TIMP-1较同期药物组显著升高,同时其6个月组MMP-1/TIMP-1比值较同期药物组显著降低(P<0.05)。结论从抑制原有胶原网络降解的角度而言,择期PCI在AMI后6个月内明显优于药物治疗,而至12个月时择期PCI未进一步显示出此方面的优越性。
Objective To evaluate influence of drug treatment and selective pereutaneous coronary intervention（PCI） on matrix metalloproteinase-1 （MMP-1）and tissue inhibitor of metalloproteinase-1 （TIMP-1）in patients with acute myocardial infarction （AMI）. Methods According to the different therapies, forty-one patients with AMI were divided into two groups ： drug treatment group （ drug group, n = 22 ） and selective PCI group （ PCI group, n = 19 ）. The serum concentration of carboxy-terminal propeptide of MMP-1 and TIMP-1 of the patients with AMI were measured by euzyme-linked immunosorbent assay on the 1st week,the 3rd month and the 6th month and the 12th month after AMI. Results Compared to the control group, the serum concentration of MMP-1 in the patients was significantly decreased on the all times after AMI in the drug treatment group and selective PC/group, and the serum concentration of TIMP-1 in the patients was also significantly decreased on the 1 st week, the 3rd month, and the 6th month（ P 〈 0.05 ）. In the drug treatment group and selective PCI group,the level of TIMP-1 of the drug treatment group was significantly higher on the 12th month than those on the 3rd month and the 6th month （ P 〈 0. 05 ）. The serum concentration of TIMP-1 of selective PCI group was significantly higher than those in the drug treatment group on the 3rd month and the 6th month （P 〈 0. 05 ）. Meanwhile, the ratio of MMP-1/TIMP-1 in selective PCI group on the 6th month was lower than in the drug treatment group（P 〈 0. 05 ）. Conclusion For inhibiting degradation of initially collagen lattice after AMI, selective PCI is better than drug treatment 6 months,while no significant differences are observed between drug treatment and selective PCI on the 12th month.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2008年第9期748-750,共3页
Chinese Journal of Practical Internal Medicine
基金
贵州省科学技术基金资助项目[黔基合计字(2003)3043]
贵州省高层次人才科研条件特助经费项目[黔人领函(2005)14]
