MMP-9和TIMP-1与急性心肌梗死后左心室重构的关系

目的探讨急性心肌梗死(AMI)患者血清基质金属蛋白酶-9(MMP-9)和金属蛋白酶组织抑制因子-1(TIMP-1)水平的变化及其与AMI后近期左心室重构(LVRM)和功能的关系。方法选择首次发病AMI患者71例,其中31例(A组)于发病12h之内(5.7±1.8)h入院给予直接经皮冠状动脉介入治疗(PCI);余40例于发病12h之后入院,待病情稳定后随机分为两组,B组20例于发病后(5.6±2.8)d行延迟PCI,C组20例给予内科保守治疗。另设正常对照组(D组)。ELISA法测血清MMP-9、TIMP-1浓度。二维超声心动图计算舒张末期容积指数(EDVI)、收缩末期容积指数(ESVI)、射血分数(EF)和室壁运动指数(WNSI)。结果EDVI、ESVI、EFA组显著优于B、C组(P<0.05);B组显著优于C组(P<0.05)。WNSIA、B组明显改善,C组恶化。A、B、C组30d时MMP-9浓度与EDVI、呈正相关(分别为r=0.48、0.54、0.63,P<0.05),与EF呈负相关(分别为r=-0.46、-0.53、-0.62,P<0.05)。结论AMI后早期血清MMP-9浓度即升高,LVRM过程中MMP-9浓度与EDVI、呈正相关,与EF呈负相关。

Relation ship between MMP-9, TIMP-1 and left ventricular remodeling after acute myocardial infarction

Objective To investigate the sequential changes in serum level of MMP-9 and TIMP-1,and evaluate the relation between MMP-9,TIMP-1 and LVRM of lately period after AMI.Methods Seventy-one patients with a first acute myocardial infarction were enrolled.Thirty-one(group A)patients were performed direct PCI.Forty patients after 12hrs from onset of symptoms were randomly assigned to delayed-PCI(groupB,20patients) or conservative therapy(group C, 20 patients),and centrol subjects (group D,20 patients).Enzyme link immuno-assay (ELISA) was used to measure serum MMP-9,TIMP-1. ESVI,EDVI,EF were evaluated by method of biplane Simpson.Results The improvement of ESVI,EDVI and EF were significant statistically between A,B and C(P<0.05,respectively) after AMI.The correlation between average serum level of MMP-9 and EDVI was positive at 30d,and was negative between average serum level of MMP-9 and EF. Conclusion During LYRM,the correlation between average serum level of MMP-9 and EDVI was positive,and the correlation between average serum level of MMP-9 and EF was negative.