【摘要】 目的:探讨血清基质金属蛋白酶-1,2,9(matrix metalloproteinases 1,2,9,MMP-1,2,9)在高血压并发急性冠脉综合征(a-cute coronary syndrome,ACS)中的变化及其临床意义。方法:正常组22例,高血压组(HBP组)26例,ACS组49例,HBP+ACS组47例。用酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA)检测各组血清MMP-1,2,9水平,免疫散射比浊法(immunoturbidimetric method)检测血清C反应蛋白(C-reactive protein,CRP)水平。分析HBP+ACS组阳性值的血清MMP-1,2,9水平,受试者工作特性曲线(receiver operating characteristic curve,ROC)。结果:HBP+ACS组血清MMP-1,2,9水平显著高于正常组、HBP组及ACS组(P<0.01),MMP-1,2,9水平与血清CRP水平呈正相关。MMP-1,2,9水平用于HBP+ACS判断的临界值分别为33.25ng/ml、613.18ng/ml和241.14ng/ml,ROC曲线下面积分别为0.763、0.858和0.895,MMP-9阳性似然比、阳性预测值及阴性预测值高于MMP-1和MMP-2,阴性似然比低于MMP-1和MMP-2。结论:血清MMP-1,2,9在HBP+ACS中呈高表达,提示血清MMP-1,2,9变化与高血压并发ACS发生发展有关,MMP-9作为预测动脉粥样斑块不稳定或破裂的血清学指标优于MMP-1和MMP-2。更多还原

【Abstract】 Objective:To explore the changes of MMP-1,2,9 in hypertension (HBP) complicated by acute coronary syndrome (ACS) and to evaluate their clinical significance.Methods:47 patients with hypertension complicated by ACS were enrolled as HBP+ACS group,and 49 patients with simple ACS as ACS group and 26 patients with simple hypertension as HBP group,22 health volunteers served as control group.MMP -1,2,9 in serum were measured with ELISA,CRP in serum was measured with immunoturbidimetric method. The receiver operating characteristic curves of serum MMP-1,2,9 were produced. Results:The levels of MMP-1,2,9 in HBP+ ACS group were significantly higher than those in HBP group,ACS group and the control group (P<0.01). Serum MMP-1,2,9 were significantly related with CRP.The cutoff values of MMP-1,2,9 level for the HBP+ACS were 33.25 ng/mL,613.18 ng/mL and 241.14 ng/mL respectively. The areas under the curves of ROC of MMP-1,2,9 were 0.763, 0.858 and 0.895. The positive likelihood ratio,positive predictive value and negative predictive value of MMP-9 were higher than MMP-1 and MMP-2,negative likelihood ratio was lower than MMP-1 and MMP-2.Conclusion:The high expression of MMP-1,2,9 in ACS+HBP suggesting that serum MMP-1,2,9 changes are correlated with the development of hypertension complicated by acute coronary syndrome.As a prediction factor for atherosclerotic plaque instability or rupture,serum MMP-9 is better than MMP-1 and MMP-2.更多还原