冠心病患者血浆sOX40L与MMP-9检测的临床意义

目的探讨冠心病患者血浆sOX40L和血清基质金属蛋白酶-9（MMP-9）变化水平及其与动脉粥样硬化易损斑块的关系。方法采用酶联免疫吸附法检测sOX40L、MMP-9。所有患者均行冠状动脉造影，计算冠状动脉病变形态积分并与sOX40L，MMP-9水平进行相关分析。结果急性冠状动脉综合征（ACS）组sOX40L及MMP-9水平显著高于稳定型心绞痛（SAP）组和正常组（P〈0．05），而后两组间差异无统计学意义（P〉0．05）；ACS组冠状动脉狭窄病变形态积分明显高于SAP组和正常组（P〈0．05），后两组间病变积分差异无统计学意义（P〉0．05）；ACS组sOX40L及MMP-9水平均与冠状动脉造影狭窄病变形态积分有明显相关性（P〈0．05）。结论冠心病患者sOX40L及MMP-9水平升高可能提示斑块不稳定。可有效判断冠状动脉病变程度预测急性冠状动脉事件的发生。

Significance of determination of sOX40L and matrix metalloproteinases-9 in patients with coronary artery disease

Objective To explore the relationship between sOX40L, MMP-9 and stability of coronary atheresclerotic plaque in patients with coronary heart disease （CHD）. Methods The morphology of plasma sOX40L and MMP-9 were determined with ELISA.. All patients were identified with coronary angiography （CAG） . All coronary stenoses with ≥ 50% diameter reduction were assessed by angiographic coronary stenosis morphology. Results （1） the level of serum sOX40L and MMP-9 in ACS group were significantly higher than SA and control groups （ P 〈 0.05） . But there was no significant difference between SA group and control group （P〉0.05） ;（2） the score of angiography morphology of coronary lesions in ACS group was significantly higher than that of SA and control groups （ P 〈 0.05）. But there were no significant difference between SAP group and control group （ P 〉0.05）;（3） the levels of sOX40L and MMP-9 were correlated with the coronary severity scores （r1 =0.52 p〈0.05, r2 =0.41 p〈0.05）.（4） Correlation analysis suggested the levels of sOX40L were positively correlated with MMP-9 （p〈0.05）. Conclusion The elevated levels of serum sOX40L, MMP-9 in ACS suggested that they may enhance the inflammation, aggravate the development of atherosclerosis and mediate the plaque destabilization . They can be served as a valuable marker for evaluating the degree of coronary artery pathology and forecasting clinical risk in ACS.