急性心肌梗塞患者行PCI前后激活素A与血清基质金属蛋白酶水平的变化

目的:探讨激活素A(ACT-A)及血清基质金属蛋白酶-9(MMP-9)在急性心肌梗塞(AMI)患者急诊介入治疗前后的变化及临床意义。方法:采用酶联免疫吸附法(ELISA)检测60例行急诊经皮冠状动脉介入(PCI)术治疗患者及30例冠状动脉造影正常者术前及术后第1 d及第3 d血清ACT-A及MMP-9的含量。结果:AMI患者术前,术后第1 d及第3 d的血浆ACT-A及MMP-9水平均明显高于冠脉造影正常者(P均0.05),AMI患者PCI术后1d、3d血清ACT-A水平均较术前明显降低[(421±224)pg/ml:(451±190)pg/ml:(551±289)pg/ml,P均0.05],血清MMP-9水平均较术前明显升高[(769±198)μg/L:(849±208)μg/L:(710±178)μg/L,P均0.05]。且MMP-9与ACT-A呈负相关(r=-0.36,P0.05)。结论:激活素A与基质金属蛋白酶-9参与了心肌梗塞的病理生理过程,二者可用作评价急性心肌梗塞患者介入术后预后的指标。

Changes of serum activin A and matrix metalloproteinase-9 levels in patients with acute myocardial infarction before and after PCI

Objective：To explore changes and clinical significance of serum activin A（ACT-A） and matrix metalloproteinase-9（MMP-9） in patients with acute myocardial infarction（AMI） before and after percutaneous coronary intervention（PCI）.Methods：The serum ACT-A and MMP-9 levels were measured by enzyme-linked immunosorbent assay（ELISA） in 60 AMI patients undergoing PCI and 30 normal controls before,1d and 3d after operation.Results：The levels of ACT-A and MMP-9 in AMI patients were significantly higher than those of normal coronary angiography subjects before,1d and 3d after PCI（P〈0.05 all）.Compared with before treatment,serum ACT-A level of AMI patients on 1d,3d after operation significantly decreased [（551±289） pg/ml vs.（421±224） pg/ml vs.（451±190） pg/ml,P〈0.05 all],and serum MMP-9 level was significantly increased [（710±178）μg/L vs.（769±198） μg/L vs.（849±208） μg/L,P〈0.05 all].MMP-9 level was negatively associated with that of ACT-A（r=-0.36,P〈0.05）.Conclusion：Activin A and matrix metalloproteinase-9 are probably involved in the pathological process of myocardial infarction.Both of them could be used to evaluate the prognosis of acute myocardial infarction patients after percutaneous coronary intervention.