冠心病心绞痛患者血浆高敏C反应蛋白和基质金属蛋白酶-9变化及其临床意义

目的探讨高敏C反应蛋白（hsCRP）及基质金属蛋白酶-9（MMP-9）在冠心病心绞痛发病机制中的作用。方法选择冠状动脉造影确诊的冠心病患者70例,分为稳定型心绞痛（SAP）组33例,不稳定型心绞痛（UAP）组37例,30例冠状动脉造影正常者作为对照组。分别采用免疫浊度法和酶联免疫吸附法检测血浆hsCRP、MMP-9水平。结果 UAP组血浆hsCRP、MMP-9水平为（2.95±0.62）mg/L、（24.29±4.73）mg/L显著高于SAP组的（1.83±0.57）mg/L和（19.83±4.63）mg/L（P〈0.01）,两组hsCRP、MMP-9均明显高于对照组（1.53±0.45）mg/L、（16.21±4.17）mg/L（P〈0.05或P〈0.01）。结论炎症介质在冠心病的发病过程中可能发挥重要作用,血浆hsCRP与MMP-9在反映冠状动脉斑块稳定性及冠状动脉病变的严重程度方面有重要的临床意义。

The alteration and significance of plasma high sensitivity C-reactive protein and matrix metalloproteinase-9 in the patients with coronary heart disease

Objective To explore the role of high sensitivity C-reactive protein（hsCRP） and matrix metalloproteinase-9（MMP-9） in the mechanism of patients with coronary heart disease（CHD）.Methods 70 patients with diagnosed as angina pectoris by coronary angiography were selected,among which there were 33 cases with stable angina patients（SAP group）,37 cases with unstable angina pectoris（UAP group）.At the same time,30 cases with normal coronary angiography were selected as control group.The level of hsCRP and MMP-9 were measured by immunonephelometry and enzyme-linked immunosorbant assay（ELISA）,respectively.Results The mean plasma levels of hsCRP and MMP-9（2.95±0.62）mg/L,（24.29±4.73）mg/L in UAP group were significantly higher than those（1.83±0.57）mg/L,（19.83±4.63）mg/L of SAP group（P 0.01）,and both were higher than those of control group（1.53±0.45）mg/L,（16.21±4.17）mg/L（P 0.05 or P 0.01）.Conclusion Inflammatory mediators might play an important role in the pathogenesis of CHD,hsCRP and MMP-9 can reflect the stability of atherosclerotic plaque and the severity of coronary artery disease.