ST段抬高性心肌梗死患者的血浆MMP-9的动态演变及临床意义

目的探讨ST段抬高性心肌梗死（STEMI）患者的m浆基质金属蛋白酶-9（MMP-9）动态演变的临r末意义。方法选择2011年9月-2012年2月的STEMI患者55例，分别在患者症状发作后4h内及4～8、8～12、12～24、24～48、48～72h不同时间段采集外周静脉血，用酶联免疫吸附试验（EI．ISA）检测各时段的血浆MMP-9水平，并与健康志愿者（健康组）50例作比较。采用GRACE评分对STEMI患者的病情进行评估，分析患者MMP9水平与GRACE的关系。结果STEMI患者在各时间段的MMP-9水平均高于健康组（P〈0．001），4h内组MMP-9的表达水平低于12～24h组和48～72h组（P〈0．05），4～8h组MMP9的表达水平低于12～24h组、24～48h组和48～72h组（P〈0．05）。患者入院时MMP-9水平与GRACE评分呈正相关（r=0．644，P〈0．001）。结论MMP9在STEMI患者症状发作4h内明昆升高，存STEMI发作12～24h后达到峰值且峰值持续72h，可作为评价心梗患者风险的指标。

The significance of the changes on serum matrix metalloproteinase-9 in patients with ST-segment elevation myocardial infarction

Objective To investigate the significance of the changes on serum Matrix metalloproteinase-9 （MMP-9） in Patients with ST-segment elevation myocardial infarction （STEMI）. Methods A total of 55 STEMI patients admitted into our hospital between September 2011 and February 2012 were recruited. The sampling was collected at six points within 4 h, 4--8 h, 8--12 h, 12--24 h, 24--48 h and 48--72 h of symptom onset. The control groups were fifty subjects of healthy volunteers respectively. The plasma lev- els of MMP-9 in venous blood were detected with enzyme-linked immunosorbent assay （ELISA）. The GRACE risk score was used for risk assessment. Results The MMP-9 level was higher in patients at all six points compared with the control group. The MMP-9 level was significantly higher in patients at 48-- 72 h （P d0.05）, 12--24 h （P d0.05） than within 4 h and the MMP-level at 12-24 h （P d0.05）, at 24 -48 h （P d0.05） , at 48--72 h （P d0.05） was significantly higher than 4--8 h. The MMP 9 level is positive MMP 9 peak of index of correlated to the GR was significantly hig MMP 9 level was 12 assessing the risk of ACE risk score （r = 0. 644, P d0. her in patients with STEMI within --24 hours after onset and the peak STEMI. 001）. Conclusion The plasma levels of 4 hours of the onset of symptoms. The lasted for 72 hours. The MMP-9 was an