急性心肌梗死血管内超声特征及与Hs-CRP、ProMMP-1和TIMP-1的关系

目的研究急性心肌梗死(AMI)冠脉斑块的血管内超声(IVUS)特征,以及与高敏C反应蛋白(Hs-CRP)、基质金属蛋白酶-1前体(ProMMP-1)、基质金属蛋白酶-1抑制剂(TIMP-1)的关系。方法冠脉介入治疗前应用IVUS研究22例AMI和68例稳定性心绞痛(SA)患者罪犯病变IVUS特征。应用ELISA方法检测血浆Hs-CRP、ProMMP-1和TIMP-1水平。结果AMI全部表现为破裂斑块和不稳定斑块,而SA主要表现为稳定斑块;AMI组罪犯病变血管外弹力膜面积、斑块负荷、脂核负荷大于SA组,纤维帽更薄,正性重构、夹层和血栓多见。AMI组Hs-CRP、ProMMP-1和TIMP-1显著高于稳定斑块组,并与斑块破裂、血栓形成、夹层和纤维帽厚度具有显著相关性。结论罪犯斑块性质和临床表现相关,AMI患者Hs-CRP、ProMMP-1和TIMP-1升高可能与斑块的不稳定性和破裂相关。

Intravascular Ultrasound Characteristics of Plaque in Acute Myocardial Infarction and the Relationship between IVUS and Hs-CRP、ProMMP-1、TIMP-1

Objective To explore the intravascular ultrasound(IVUS) characteristics of plaque in acute myocardial infarction(AMI),and to investigate the relationship between IVUS and hyper-sensitive C-reactive protein(Hs-CRP)、Pro-matrix metalloproteinase-1(ProMMP-1)、tissue inhibitors of matrix metalloproteinase-1(TIMP-1).Methods The culprit lesions were measured in 22 cases of AMI and 68 cases of SA by IVUS before coronary intervention.The plasma levels of Hs-CRP、ProMMP-1 and TIMP-1 were determined by ELISA.Results No stability plaque was discovered in AMI,which was mainly observed in SA.External elastic membrane cross-sectional area、plaque burden in AMI were significantly larger than those in SA.Positive remolding、 thinner fabric-cap、smaller minimal lumen cross-sectional area、dissection and thrombus were significantly more frequent in AMI.The levels of plasma Hs-CRP、ProMMP-1 and TIMP-1 were significantly higher in AMI than in SA. Hs-CRP、ProMMP-1 and TIMP-1 levels were correlated with plaque rupture、fabriccap、dissection and thrombus.Conclusions The IVUS characteristics in AMI are different from those in SA.The elevation of Hs-CRP、ProMMP-1 and TIMP-1 in AMI may correlate with the plaque instability and rupture.