【摘要】 目的:探讨基质金属蛋白酶(MMP)1、3及组织型基质金属蛋白酶抑制物2(TIMP2)水平改变与急性冠状动脉综合征(ACS)及非ACS之间的关系,为临床早期诊治ACS提供客观指标。方法:230例于2008-01至2011-06行冠状动脉(冠脉)造影的心内科住院患者,依临床及冠脉造影分组:ACS组98例,包括不稳定型心绞痛亚组61例、急性心肌梗死亚组37例;非ACS组81例,包括稳定型心绞痛亚组49例、冠脉慢性完全闭塞亚组32例;对照组51例(正常冠脉)。于冠脉造影后抽动脉血检测血浆MMP1、MMP3、TIMP2水平。结果:与对照组比较,MMP1在ACS组及非ACS组均明显增高(P均<0.001);MMP3在ACS组显著增高(P<0.01),非ACS组无明显增高(P>0.05);TIMP2在非ACS组中显著增高(P均<0.01)。与非ACS组比较,ACS组MMP1、MMP3增高及TIMP2降低差异均有统计学意义(P均<0.05)。亚组分析中,与对照组相比,各亚组MMP1水平增高(P<0.05～0.001);MMP3在不稳定型心绞痛亚组及急性心肌梗死亚组均显著增高,TIMP2在稳定型心绞痛亚组及冠脉慢性完全闭塞亚组均显著性增高(P均<0.001),差异均有统计学意义。结论:ACS及非ACS患者血浆MMP1水平增高提示MMP1可能与冠心病发生有关;MMP3水平仅于ACS患者中增高提示MMP3可能为ACS发生的重要影响因素;TIMP2水平增高只出现于非ACS患者提示TIMP2增高可能有益于斑块的稳定性。更多还原

【Abstract】 Objective:To study the relationship between acute coronary syndrome(ACS) or Non-ACS and plasma levels of matrix metalloproteinase-1(MMP1),MMP3,tissue inhibitor-2 of matrix metalloproteinase(TIMP2) in order to provide early diagnosis and treatment in ACS patients. Methods:A total of 230 patients treated in our hospital from January 2008 to June 2011 were divided into 3 groups according to clinical examination and coronary angiography(CAG).ACS group,n=98 that including unstable angina pectoris(UAP) subgroup of 61 patients and acute myocardial infarction(AMI) subgroup of 37 patients.Non-ACS group,n=81 that including stable angina pectoris(SAP) subgroup of 49 patients and chronic total occlusion of coronary artery(CTO) subgroup of 32 patients.Control group,n=51,the patients with normal coronary artery.Plasma levels of MMP1,MMP3 and TIMP2 were evaluated and compared in all groups after CAG. Results:Compared with Control group,MMP1 increased in both ACS and NON-ACS groups,P<0.001 respectively;MMP3 increased in ACS group,P<0.01,while it was unchanged in Non-ACS group,P>0.05;TIMP2 increased in Non-ACS group,P<0.01.Compared with Non-ACS group,MMP1,MMP3 increased and TIMP2 decreased in ACS group,P<0.05 respectively.Compared with Control group,MMP1 increased in all subgroups,P<0.05~0.001;MMP3 elevated in both UAP and AMI subgroups,TIMP2 elevated in both SAP and CTO subgroups,P<0.001 respectively. Conclusion:Increased MMP1 might be related to coronary artery disease occurrence,elevated MMP3 could be an important factor in ACS occurrence,while higher level of TIMP2 may stabilize the atherosclerotic plaque.更多还原