【摘要】 目的探讨血清基质金属蛋白酶9(MMP-9)水平对早期主动脉夹层(AD)的诊断价值及预后评估作用。方法选择2011年1月—2014年1月在广州市第一人民医院心内科及广州市南沙中心医院心内科住院的AD患者60例,根据主动脉计算机断层扫描血管造影(CTA)结果分为Stanford A型32例(A组)和Stanford B型28例(B组);另选取同期在我院体检健康者30例作为对照组。采用酶联免疫吸附法(ELISA)检测3组受试者血清MMP-9水平。结果 A组患者血清MMP-9水平为(56.31±10.36)μg/L,B组为(45.73±9.57)μg/L,对照组为(25.35±7.58)μg/L,A组、B组患者血清MMP-9水平均高于对照组,A组高于B组(P<0.05)。绘制受试者工作特征(ROC)曲线发现,血清MMP-9水平诊断早期AD的曲线下面积为0.915,标准误为0.04,最佳临界值为48.75μg/L,取最佳临界值时血清MMP-9水平诊断早期AD的敏感度为95%,特异度为88%(P<0.05)。本组60例AD患者48 h内共死亡16例,存活44例,死亡者血清MMP-9水平〔(66.98±12.52)μg/L〕高于存活者〔(45.83±9.23)μg/L,P<0.05〕。结论检测血清MMP-9水平有助于早期诊断AD及评估患者预后。更多还原

【Abstract】 Objective To investigate the diagnositic value and prognostic evaluation of matrix metalloproteinase 9( MMP-9) on aortic dissection( AD) at early stage. Methods 60 AD patients admitted to Department of Cardiology,Nansha Centeral Hospital of Guangzhou and Department of Cardiology,the First People’s Hospital of Guangzhou,were selected and divided into Stanford A type( group A,n = 32) and Stanford B type( group B,n = 28),according to aotra CTA. At the same time,30 healthy subjects were selected as control group. Serum MMP- 9 levels were detected by enzyme- linked immunosorbent assay( ELISA) of the three groups. Results The serum MMP- 9 level of group A was( 56. 31 ± 10. 36) μg /L,group B was( 45.73 ±9. 57) μg/L,and control group was( 25. 35 ±7.58) μg/L; serum MMP-9 levels of groups A and B were significantly higher than that of control group,group A was higher than that of group B( P < 0. 05). ROC curve showed that the area under curve of serum MMP- 9 level in diagnosis of AD at early stage was 0. 791,standard error was 0. 04,the best threshold was48. 75 μg /L,and its sensitivity was 95%,specificity was 88%. In the 60 AD patients,16 patients died in 48 hours,44 patients was alive,the serum MMP- 9 level of died cases was( 66. 98 ± 12. 52) μg /L,was significantly higher than that of alive cases of( 45. 83 ± 9. 23) μg /L( P < 0. 05). Conclusion Detecting serum MMP- 9 level is helpful in diagnosis of AD at early stage and prognosis elaluation.更多还原