缺血性心脏病患者血浆基质金属蛋白酶2和基质金属蛋白酶9与心脏重塑关系

目的探测缺血性心脏病（IHD）患者血浆基质金属蛋白酶2（MMP-2）、MMP-9活性水平与心脏重塑指标左心室质量指数（LVMI）之间的关系。方法选取2007年5月至2010年9月北京安贞医院住院的IHD患者254例，根据LVMI不同分为心脏重塑组（128例）和非心脏重塑组（126例）。对照组为214例门诊健康体检心脏功能正常的健康人。利用明胶酶谱方法测定各组受试者血浆MMP．2、MMP-9的活性水平，分析两者与心脏重塑指标的关系。结果心脏重塑组患者血浆MMP-2、MMP-9的活性高于对照组和非心脏重塑组[MMP-2：（13．0±2．9）m2／（g·L^-1）比（8．9±2．3）、（10．9±2．9）m2／（g·L^-1）；MMP-9：（2．6±1．0）m2／（g·L^-1）比（1．4±0．4）、（2．1±0．7）m2／（g·L^-1），均P〈0．05]，非心脏重塑组患者的MMP-2、MMP-9活性水平高于对照组（P〈0．05）。血浆MMP-2、MMP-9活性水平与LVMI明显相关（r=0．464、0．516，均P〈0．05）。结论MMP-2、MMP-9在IHD患者心脏重塑的发生和发展过程中起着一定作用，有可能用来预测IHD患者发生心脏重塑的进展及预后。

Relationship between matrix metalloproteinase 2, 9 in plasmas of patients with ischemic heart disease and cardiac remodeling

Objective To investigate the relationship between the activities of matrix metalloproteinase 2 （MMP-2） , MMP-9 respectively in the plasmas of patients with ischemie heart disease （ IHD ） and left ventricular mass index （LVMI）. Methods A case-control study with 254 IHD patients （observation group）and 214 control subjects （control group） frequency-matchod by age and sex were conducted. The 254 patients with IHD were divided into cardiac remodeling group（ 128 cases） and non-remodeling group（ 126 eases） according to the levels of LVMI. The activity levels of plasma MMP-2 and MMP-9 were assayed by zymography. Results The activity of MMP-2 in cardiac remodeling group were significantly higher than those in control group and non-remodeling group [ MMP-2： （13.0±2.9）m2/（g·L^-1）vs（8.9±2.3）, （10.9±2.9）m2/（g·L^-1）;MMP-9： （2.6±1.0）m2/（g·L^-1） vs （ 1.4 ±0.4）, （ 2.1 ± 0.7 ） m2/（g·L^-1）, all P 〈 0.05 ] ; the activity of MMP-9 and MMP-2 both in non-remode- ling group of IHD patients were significantly higher than those in control group （ P 〈 0.05 ）. The activity of the en- zymes was correlated with cardiac remodeling （LVMI） （P 〈 0.05）. Conclusion MMP-2 and MMP-9 in the plasma may have a role in the progression and/or acceleration of the left ventricular remodeling in heart failure and they may play important roles in the progression and/or acceleration of cardiac remodeling.