冠心病患者血清MMP-9与Hcy的临床意义

目的探讨冠心病患者血清同型丰胱氨酸（Hcy）、基质金属蛋白酶-9（MMP-9）水平与冠脉斑块性质的相关性及临床意义。方法选择72例疑诊冠心痛患者，所有入选患者均行冠脉造影及64层螺旋CT冠脉扫描，冠心病的诊断标准为冠脉至少一支血管狭窄程度≥50％，并根据斑块的CT值分为软斑块组（11例）、混合斑块组（14例）、硬斑块组（25例）及对照组（22例）。依冠脉造影结果分型为急性冠脉综合征（ACS）组（24例）与稳定型心绞痛（SAP）组（26例）。同时以ELISA法测定血清MMP-9及用化学发光法测血清Hcy，比较各组的差异及相互关系。结果软斑块组与混合斑块组血清Hcy、MMP-9水平高于硬斑块组和对照组（P〈0．05），MMP-9水平与Hcy水平显著正相关（r=0．657，P〈0．05）。结论MMP-9、Hcy与斑块的不稳定性密切相关，64层螺旋CT冠脉斑块检查联合血清Hcy、MMP-9水平检测可作为冠脉斑块不稳定性的预测指标。

Clinical Significance of MMP - 9 and Homocysteine in Coronary Artery Disease

Objective To explore the relationship between quality of coronary plaque and serum concentrations of homocysteine （Hey） and matrix metalloproteinase- 9 （MMP- 9） in coronary heart disease （CHD）. Methods Seventy - two patients （pts） with CHD were selected, one or more artery stenosis level was more than 50%. All pts were studied by 64- channel MSCT and coronary angiography. There were 11 pts in soft plaque group, t4 pts in mixed plaque group,25 pts in hard group and 22 pts in control group by CT. Twenty- four pts with ACS and 26 pts with SAP were studied by coronary angiography. MMP - 9 and Hcy were detected and compared. Results The concentrations of MMP - 9 and Hcy in soft plaque group and mixed plaque group were higher than that in hard plaque group and control group （P〈0.05）. The MMP - 9 was related to Hcy （r=0. 657, P〈0.05）. Conclusion The concentration of MMP - 9 was related to Hcy and plaque instability positively. The instability of plaque could be evaluated by 64 - channel spiral computed tomography, and concentration of MMP - 9 and Hcy.