基质金属蛋白酶9及其抑制剂与老年高血压患者颈动脉粥样硬化程度的相关性

目的探讨基质金属蛋白酶9(mctalloprotemase-9,MMP-9)及组织基质金属蛋白酶抑制剂1(TIMP-1)与老年高血压患者颈动脉粥样硬化程度的相关性。方法选择老年高血压患者330例,应用高分辨超声测量颈动脉内膜中层厚度(IMT)及斑块情况,将患者分为4组:IMT正常组(26例)、IMT增厚组(80例)、稳定性斑块组(135例)和不稳定性斑块组(89例),测定血清生化指标、MMP-9、TIMP-1水平,进行组间比较。结果 IMT正常组、IMT增厚组、稳定性斑块组和不稳定性斑块组血清MMP-9、TIMP-1水平逐渐增高,不稳定性斑块组MMP-9/TIMP-1比值明显高于其他3组,差异有统计学意义(P<0.01)。取所有高血压患者进行多元线性逐步回归分析,颈动脉IMT与年龄、收缩压、LDL-C、空版(?)(?)相关(P<0.05,P<0.01);logistic回归分析显示,颈动脉是否存在斑块与体重指数、收缩压、LDL-C、logMMP-9相关(P<0.05,P<0.01)。取颈动脉斑块患者进行logistic回归分析,斑块是否稳定与收缩压、LDL-C、logMMP-9(模型1,P<0.05,P<0.01)或收缩压、LDL-C、logMMP-9/TIMP-1比值(模型2,P<0.05)相关。结论老年高血压患者血清MMP-9水平、MMP 9/TIMP-1比值与颈动脉是否存在斑块及其稳定性密切相关。

Relation of metalloproteinase 9 and its inhibitor with carotid artery atherosclerosis in aged patients with hypertension

Objective To study the relation of metalloproteinase-9(MMP-9) and its inhibitor,metalloproteinase -1(TIMP-1),with carotid artery atherosclerosis in aged patients with hypertension. Methods Three hundred and thirty patients with hypertension were divided into normal-intima media thickness(IMT) group(n= 26) increased IMT group(n= 80).stable plaque group(n=135) and unstable plaque group(n= 89).Their IMT and carotid plaques were detected by high resolution B mode ultrasonography and their serum levels of biochemical indicators,MMP-9 and TIMP-1,were measured and compared.Results The serum MMP-9 and TIMP-1 levels increased gradually in the 4 groups and were higher in the unstable plaque group than in the other 3 groups (P<0.01).Multiple linear stepwise regression analysis showed that the IMT was positively related with the age,systolic blood pressure,LDL-C and fasting blood sugar of patients with hypertension (P<0.05,P<0.01).Logistic regression analysis showed that the carotid plaque was positively related with the body mass index,systolic blood pressure,LDL-C and logMMP-9 of patients with hypertension(P<0.05,P<0.01).Conclusion Serum MMP-9 level and MMP-9/TIMP-1 ratio are closely related with carotid plaque and its stability in aged patients with hypertension.