细胞外基质金属蛋白酶诱导因子与冠心病临床类型的关系

目的 探讨基质金属蛋白酶（MMPs）上游调控因子细胞外基质金属蛋白酶诱导因子（EMMPRIN）与动脉粥样硬化形成及冠心病临床类型的关系。方法 根据临床表现和冠状动脉造影结果，223例患者分成ST段抬高心肌梗死（STEMI）组（n=65）、非ST段抬高急性冠状动脉综合征（NSTE ACS）组（n=42）、稳定型心绞痛（SAP）组（n=75）、冠状动脉造影正常组（正常对照组，n=41）。使用流式细胞仪检测患者外周血单核细胞（PBMCs）表面EMMPRIN的平均荧光强度（MFI）；ELISA法测定血清中MMP-9的质量浓度；免疫速率法检测血清高敏C反应蛋白（hs-CRP）的质量浓度。结果 SAP组、STEMI组及NSTEACS组PBMCs表面EMMPRIN MFI均高于正常对照组（P<0.05或P<0.01）；而STEMI组和NSTE ACS组又高于SAP组（P<0.05或P<0.01）。各组中PBMCs表面EMMPRIN的表达特点与hs-CRP和MMP-9的表达特征一致。相关性分析显示，PBMCs表面的EMMPRIN MFI 与血清MMP-9、hs-CRP质量浓度呈正相关（r=0.168，P<0.05；r=0.305，P<0.01）。结论 EMMPRIN作为MMPs上游调控因子可能对动脉粥样硬化形成和冠心病的不稳定有促进作用。

Relationship between extracellular matrix metalloproteinase inducer and clinical type of coronary heart disease

Objective To investigate the relationship between extracellular matrix metalloproteinase inducer (EMMPRIN), the upstream regulatory factor of matrix metalloproteinase (MMPs), and the formation of atherosclerosis and the clinical type of coronary heart disease. Methods A total of 223 patients were classified into four groups according to results of coronary angiography (CAG) and clinical data: STEMI group (65 patients with ST-segment elevation myocardial infarction), NSTE ACS group (42 patients with non-ST-segment elevation acute coronary syndrome), SAP group (75 patients with stable angina pectoris) and normal control group (41 patients of CAG-negative). The mean fluorescence intensity (MFI) of EMMPRIN on monocytes of peripheral blood (PBMCs)were examined by flow cytometry. MMP-9 in serum was measured with ELISA; high-sensitivity C-reactive protein (hs-CRP) in serum was measured with immune velocity method. Results The EMMPRIN MFI on PBMCs in SAP group, STEMI group and NSTE ACS group was higher than that in the normal control group (P<0.05 or P<0.01). The EMMPRIN MFI in STEMI group and NSTE ACS group was higher than that in SAP group (P<0.05 or P<0.01). The expression characteristic of EMMPRIN on the PBMCs was consistent with that of hs-CRP and MMP-9 in each group. The EMMPRIN MFI of the PBMCs had positive correlation with the level of MMP-9 and hs-CRP in serum (r=0.168,P<0.05;r=0.305,P<0.01). Conclusion EMMPRIN may has promotive effect on the formation of atherosclerosis and unstablility of coronary heart disease as an upstream regulatory factor of MMPs