摘要
目的观察不同类型冠心病患者MMP2和MMP9水平的变化,探讨MMP2和MMP9在预测急性冠脉综合征(ACS)中的临床意义。方法在我院心内科住院患者118例,依临床表现和冠脉造影结果分为ACS组(49例),包括不稳定性心绞痛亚组(UAP)30例和急性心肌梗死亚组(AMI)19例;非ACS冠心病组患者(44例),包括稳定性心绞痛亚组(SAP)23例、冠脉慢性完全闭塞亚组(CTO)21例。对照组为正常冠状动脉组(NCA)25例。用夹心酶联免疫吸附法(ELISA)检测动脉血浆MMP2、MMP9水平。结果ACS组患者血浆MMP9、MMP2水平明显高于NCA组(P<0.01)和非ACS冠心病组(P<0.05);非ACS冠心病组MMP9水平(P<0.001)和MMP2水平(P<0.05)也较NCA组明显升高。与NCA组比较,UAP亚组、AMI亚组及CTO亚组MMP9显著增高(P<0.01),MMP2也明显增高(P<0.05)。与SAP和UAP亚组比较,AMI亚组只有MMP9水平增高(P<0.05),而CTO亚组MMP9、MMP2水平均明显升高(P<0.01);CTO亚组MMP9、MMP2水平明显高于AMI亚组(P<0.05)。结论患者血MMP2、MMP9水平显著升高提示了粥样斑块的不稳定性,并与ACS病情严重程度相一致,有可能作为ACS的预测指标之一,并可能是诊断冠脉慢性完全闭塞很好的生物标志物。
Objective To investigate the changes in plasma matrix metalloproteinases-2 and -9 （MMP2 and MMP9, respectively） levels in patients with different types of coronary heart diseases （CHD）, and assess the value of MMP2/MMP9 detection in predicting acute coronary syndrome （ACS）. Methods According to the findings by coronary angiography and the clinical manifestations, 118 patients were divided in ACS group including 30 patients with unstable angina pectoris （UAP） and 19 with acute myocardial infarction （AMI） and non-ACS group including 23 patients with stable angina pectoris （SAP） and 21 with chronic total occlusion （CTO） of the coronary artery. Twenty-five individuals with normal coronary artery （NCA） served as the control group. Plasma levels of MMP9 and MMP2 were determined in these subjects using enzyme-linked immunosorbent assay （ELISA）. Results Both the ACS and non-ACS groups showed significantly higher MMP9 and MMP2 levels than the NCA group （P〈0.05）, and MMP2 and MMP9 levels were significantly higher in ACS group than in non-ACS group （P〈0.05）. Compared with the NCA group, the UAP, AMI and CTO subgroups showed obvious increases in plasma MMP2 and MMP9 levels （P〈0.01）. Significantly increased MMP9, but not MMP2 level was noted in AMI subgroup in comparison with SAP （P〈0.01） and UAP subgroups （P〈0.05）; both MMP2 and MMP9 levels were elevated in CTO subgroup in comparison with those in SAP （P〈0.001）, UAP （P〈0.01）, and AMI subgroups （P〈0.05）. Conclusion Increased MMP2 and MMP9 levels in patients with CHD suggest the instability of the atlrerosclerotic plaque in correlation to the severity of ACS, and may serve as good indicators for the prediction of ACS and diagnosis of CTO of the coronary artery.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2009年第5期1004-1007,共4页
Journal of Southern Medical University
