病毒性心肌炎患儿血清基质金属蛋白酶-9的变化及意义

目的探讨病毒性心肌炎(VMC)患儿血清基质金属蛋白酶-9(MMP-9)的变化,进一步确定其临床应用价值。方法检测58例病毒性心肌炎患儿和36例健康对照组儿童的血清MMP-9、心肌肌钙蛋白(IcTnI)和肌酸激酶同工酶(CK-MB),并行心脏彩超多普勒(UCG)检测左室射血分数(LVEF)、左室短轴缩短率(LVSF)与心脏指数(CI)。结果病毒性心肌炎患儿血清MMP-9、cTnI和CK-MB水平较健康对照组明显升高(P0.01),治疗后较治疗前明显下降(P0.01)。MMP-9与cTnI、CK-MB、LVSF呈显著正相关(r=0.628,0.591,0.706,P0.01);与LVEF、CI呈负相关(r=-0.722,P0.01;r=-0.365,P0.05)。心功能分级Ⅱ、Ⅲ、Ⅳ血清MMP-9水平不同,心功能愈差,MMP-9水平愈高,差异有显著性(P0.01)。结论血清MMP-9水平可作为病毒性心肌炎诊断及判断心功能及预后的指标。

Change and Significance of Serum Matrix Metalloproteinase-9 in Viral Myocarditis in Children

Objective To detect serum matrix metalloproteinase-9（MMP-9） level in viral myocarditis（VMC） in children in an attempt to confirm its clinical value. Methods Fifty-eight children with VMC were chosen as positive group and 36 healthy children were chosen as control group. The serum MMP-9, cTnI and CK-MB levels of the two groups were detected. The LVEF, LVSF and CI were measured by two-dimensional echocardiography. Results The levels of MMP-9, cTnI and CK-MB in patients with VMC were obviously higher than those in the control group（P〈0.01 ）. After treatment they all went down（P〈0.01 ）. MMP-9 had a positive correlation with cTnI, CK-MB and LVSF （r=0.628,0.591,0.706, P〈0.01）, and had a negative correlation with LVEF （r=-0.722,P〈0.01） and CI （r=0.365,P〈0.05）. The MMP-9 level was different from various heart function, and higher the MMP-9 level, the worse heart function, with a significant difference （P〈0.01）. Conclusion MMP-9 is a guide line of diagnosis, cardiac function and prognosis in patients with VMC.