心肌梗死患者血清MMP-9的表达特征及补肾活血中药干预作用

目的]观察心肌梗死患者血清基质金属蛋白酶-9(MMP-9)的表达情况,分析MMP-9的变化特征,探讨补肾活血中药的干预作用。方法]选择急性心肌梗死(AMI)患者36例,陈旧性心肌梗死患者20例,健康者10例。将AMI患者随机分为补肾活血中药组(常规药物加补肾活血中药)和对照组(常规药物),观察2周。于入院后1 h、24 h、3 d、5 d、7 d、14 d采集肘静脉血,酶联免疫吸附法(ELISA)检测血清MMP-9表达水平,免疫比浊法检测C-反应蛋白(CRP),免疫印迹法检测肌钙蛋白I(CTn I)。结果]AMI患者血清MMP-9表达水平入院后1 h显著高于陈旧性心梗患者和健康者(P0.01),入院后3 d继续升高,5 d达高峰,后逐渐下降,7 d后持续回落,至14 d显著低于入院后1 h水平(P0.01),与CTn I和CRP均呈正相关性。补肾活血中药组治疗后MMP-9的表达水平显著低于对照组治疗后(P0.05)。结论]AMI患者前期MMP-9表达水平与CTn I、CRP基本一致,但高表达期持续时间更长。补肾活血中药能够降低MMP-9表达水平。

The expressional features of MMP-9 in serum of patients with myocardial infarction and the intervention of traditional Chinese medicine for invigorating kidney and activating blood

Objective] To observe the expressional situation of of matrix metalloproteinases-9 (MMP-9) in serum of the patients with myocardial infarction,and analyze the changing characteristics of MMP-9,and to explore the intervention of traditional Chinese medicine for invigorating kidney and activating blood. Methods] The 36 patients with acute myocardial infarction (AMI), 20 patients with chronic myocardial infarction, 10 cases of healthy subjects,which were randomly divided into a traditional Chinese medicine for invigorating kidney and activating blood group (conventional drugs plus traditional Chinese medicine for invigorating kidney and activating blood) and a control group(conventional drugs),and observed the two groups for two weeks. Collected the venous blood 1 h, 24 h,3 d,5 d,7 d and 14 d after the hospital, detectd the serum level of the expression of MMP-9 with enzyme-linked immunosorbent (ELISA), and detected the C-reactive protein (CRP) with immune turbidimetric method, and detected the troponin I (CTnI) with western blot method. Results] The expressional level of serum MMP-9 of patients with AMI was significantly higher than that of patients with chronic myocardial infarction (AMI) and the healthy subjects (P<0.01) 1 h after patients admitted to the hospital, and it was continued to rise 3 days after patients admitted to hospital,and it reached the peak 5 days after patients admitted to hospital, afterly it was gradually to decline, and continued to fall 7 days after patients admitted to hospital, and 14 days after patients admitted to hospital the level was lower than the level of 1 h after patients admitted to hospital(P<0.01), and which were positively correlated to the CTnI and CRP. The expressional level of MMP-9 of traditional Chinese medicine for invigorating kidney and activating blood group was significantly lower than that in control group after treatment (P<0.05). Conclusion] The expressional level of MMP-9 of the patients with AMI was consistent with CTnI and CRP at early stage,but the highly expressed period was lasted longer. Traditional Chinese medicine for invigorating kidney and activating blood can reduce the expressional level of MMP-9.