冠心病患者介入治疗后血CRP、MMP-9水平与预后的关系

目的：探讨冠心病（CHD）患者介入治疗前后外周血 C 反应蛋白（CRP）、基质金属蛋白酶-9（MMP-9s）水平变化，并分析其与患者预后之间的关系。方法：入选2009年7月～2011年4月在我院行冠脉支架植入术的CHD 患者278例为介入组，未行支架植入的 CHD 患者234例为 CHD 对照组。根据冠脉造影结果，介入组进一步分为单支（143例）、双支（92例）和三支病变组（43例）。比较两组患者不同时间 CRP、MMP-9水平变化，并分析其与冠脉病变及患者预后之间的关系。结果：与入院时比较，支架植入术后24h，48h，介入组患者 CRP （2.43±0.62）mg/L 比（2.87±0.73）mg/L，（2.98±0.87）mg/L]、MMP-9水平（12.63±2.68）ng/ml 比（14.62±3.49）ng/ml，（19.62±4.63）ng/ml]显著上升（P ＜0.05～＜0.01）；而术后第14d 与患者入院时差异无统计学意义，P ＞0.05；CHD 对照组患者在治疗过程中 CRP 和 MMP-9水平差异均无统计学意义，P ＞0.05；冠脉病变越严重，CRP、MMP-9水平越高，三支病变组的 CRP、MMP-9水平（2.51±0.64）mg/L，（14.67±2.97）ng/ml]显著高于单支病变（1.83±0.51）mg/L，（9.68±1.42）ng/ml]、双支病变组（2.17±0.59）mg/L，（11.62±2.19） ng/ml]，P ＜0.05～＜0.01；CRP≥3 mg/L、MMP-9≥15 ng/ml 者心血管事件发生率（33.3％、29.1％）分别显著高于 CRP ＜3 mg/L、MMP-9＜15 ng/ml 者（16.1％、18.2％），差异均有统计学意义，P 均＜0.05。结论：冠心病患者行支架植入术后48h 内其血清 C 反应蛋白、基质金属蛋白酶-9水平显著升高，并且升高水平与冠脉病变程度及预后有关。

Relationship among blood levels of CRP and MMP-9 and prognosis in patients with coronary heart dis-ease and PCI

Objective：To explore changes of peripheral blood levels of C reactive protein （CRP）and matrix metallo-proteinase-9 （MMP-9）in patients with coronary heart diseases （CHD）and percutaneous coronary intervention （PCI）,and analyze their relationship with patients＇prognosis.Methods：A total of 278 CHD patients undergoing PCI in our hospital from Jul 2009 to Apr 2011 were regarded as PCI group;another 234 CHD patients not receiving PCI were enrolled as CHD control group.According to results of coronary angiography,PCI group was further di-vided into single-vessel （n=143）,double-vessel （n=92）and triple-vessel disease group （n=43）.Changes of CRP and MMP-9 levels were compared between two groups in different time,and the relationship among these two in-flammatory factors and coronary disease,its prognosis was analyzed.Results：Compared with on admission,there were significant rise in levels of CRP （2.43±0.62）mg/L vs.（2.87±0.73）mg/L,（2.98±0.87）mg/L]and MMP-9 （12.63±2.68）ng/ml vs.（14.62±3.49）ng/ml,（19.62±4.63）ng/ml]in PCI group on 24h and 48h after PCI,P 〈0.05~〈0.01;there were no significant difference in CRP and MMP-9 levels between on admission and 14d after PCI,P 〉0.05;The more severe coronary lesion was,the higher CRP and MMP-9 levels were,CRP and MMP-9 levels of triple-vessel group （2.51 ±0.64）mg/L,（14.67±2.97）ng/ml]were significantly higher than those of single-vessel group （1.83±0.51）mg/L,（9.68±1.42）ng/ml]and double-vessel group （2.17±0.59） mg/L,（11.62±2.19）ng/ml],P 〈0.05~〈0.01;incidence rates of cardiovascular events in patients with CRP≥3 mg/L and MMP-9≥15 ng/ml （33.3%,29.1%）were significantly higher than those of patients with CRP 〈3 mg/L and MMP-9〈15 ng/ml （16.1%,18.2%）respectively,P 〈0.05 both.Conclusion：Serum levels of CRP and MMP-9 significantly rise in CHD patients on 48h after PCI,and their increasing level is related with extent of coronary ar-tery lesion and prognosis.