冠心病患者血清Ⅰ型胶原羧基末端肽的表达变化及临床意义

目的检测冠心病患者血清中Ⅰ型胶原羧基末端肽（ICTP）的水平变化，探讨其与MMP-2、MMP-9相关性，及在冠心病中
的临床意义。方法纳入2013年10月~2014年03月在我院门诊和住院的冠心病患者103例，其中稳定型心绞痛（SAP）患者39
例，不稳定型心绞痛（UA）患者39例，急性心梗（AMI）患者25例，选取38名非冠心病患者为对照组（Control, C）。留取研究对象
5 ml静脉血，用夹心酶联免疫吸附法（ELISA）检测静脉血清（基质金属蛋白-2）、MMP-9、ICTP水平，组间比较采用单因素方差分
析。结果SAP 与C 组比较，血清MMP-2，MMP-9，ICTP 水平稍增高，P>0.05。UA 组与SAP 组、C 组比较血清MMP-2、
MMP-9、ICTP水平升高，P<0.05。AMI组与SAP组及C组比较，血清MMP-2、MMP-9、ICTP升高，P<0.05。AMI组与UA组比
较，血清MMP-2、MMP-9、ICTP均无显著差异，P>0.05。ICTP与MMP-2、MMP-9都具有正相关性（P<0.05）；与斑块纤维组成比
例呈负相关，与脂质比例呈正相关（P<0.05）。结论冠心病患者血清ICTP水平升高可提示粥样斑块的不稳定性，与MMP-2水平
相关，可作为无创性的ACS的预测指标。

Changes in serum level of carboxy-terminal telopeptide of type I collagen in patientswith coronary heart disease

Objective To investigate the serum level of carboxy-terminal telopeptide of type I collagen (ICTP) and explore its
correlation with MMP-2 and MMP-9 in patients with coronary artery disease (CHD). Methods A total of 103 CHD patients
treated in our hospital between October, 2013 and May, 2014 were enrolled, including 39 with stable angina pectoris (SAP), 39
with unstable angina (UA), and 25 with acute myocardial infarction (AMI), with 38 non-CHD volunteers as the control group.
The serum levels of ICTP, MMP-2, and MMP-9 were detected in all the subjects using enzyme-linked immunosorbent assay
(ELISA). Results No significant difference in serum levels of MMP-2, MMP-9, or ICTP was found between the control and SAP
groups or between UA and AMI groups (P>0.05), but the latter two groups had significantly higher serum levels of MMP-2,
MMP-9, and ICTP than the former two groups (P<0.05). Serum ICTP level was found to negatively correlated with the fibrotic
area and positively with the lipid component in the plaques (P<0.05). Regression analysis revealed significant positive
correlations of serum ICTP with MMP-2 and MMP-9 (P<0.05). Conclusions An elevated serum ICTP level is indicative of the
presence of unstable plaques in CHD patients. Serum ICTP is more strongly correlated with MMP-2 than with MMP-9, and
can be used as a non-invasive marker for assessing vulnerable plaques in patients with acute coronary syndrome.