冠心病患者单核源巨噬细胞体外分泌的基质金属蛋白酶-9、组织因子临床意义的探讨

目的探讨单核源巨噬细胞分泌的基质金属蛋白酶-9（MMP-9）、组织因子（TF）在冠心病中的临床意义。方法密度梯度离心法提取12名急性心肌梗死（AMI）、16名不稳定心绞痛（UAP）、12名稳定型心绞痛（SAP）患者和8名冠脉正常者（Norm）的单核细胞，用佛波酯诱导其分化为巨噬细胞，ELISA法测定单核源巨噬细胞上清液MMP-9、TF含量。结果AMI、UAP组单核源巨噬细胞体外分泌MMP-9、TF的含量明显高于SAP、Norm组（P〈0．05和〈0．01），但AMI与UAP组间、SAP与Norm组问均无统计学差异，且MMP-9、TF含量与年龄、冠脉病变积分无统计学相关，在不同冠心病危险因素组间（0、1—2、3—4、4个以上危险因素）亦无统计学差异。结论单核源巨噬细胞体外分泌MMP-9、TF可作为急性冠脉综合征（ACS）病情评估的参考指标。

The clinical significance of matrix metalloproteinase-9 and tissue factor secreted by monocyte derived-macrophages in vitro in coronary heart disease

Objective To investigate the clinical significance of matrix metalloproteinase-9(MMP-9) and tissue factor(TF) secreted by monocyte derived-macrophages in vitro in coronary heart disease(CHD).Methods Monocytes in peripheral blood were obtained from 12 patients with acute myocardial infarction(AMI),16 unstable angina pectoris(UAP),12 stable angina pectoris(SAP) and 8 normals(Norm) by ficoll density gradient centrifugalization.The cells were incubated for 48 hours to induce them to differentiate into macrophages by adding phorbolester 12-myristate 13-acetate(PMA).The levels of MMP-9 and TF in the supernatant were measured by ELISA.Results It was found that the levels of MMP-9 and TF were significantly higher in AMI and UAP groups than those in SAP and Norm groups(P<0.05 and P<0.01 respectively).But there were no significant differences in them between AMI group and UAP group,or between SAP group and Norm group.Moreover,nor were there any statistical differences in the levels of MMP-9 and TF among the different CHD risk factor ranks(0,1-2,3-4 and more than 4 risk factors),or any correlation of the MMP-9 and TF levels to the age and the coronary artery score.Conclusion The levels of MMP-9 and TF secreted by macrophages in patients with CHD in vitro could be referred to as an index to estimate the condition of acute coronary syndrome(ACS).