冠心病患者缺血再灌注治疗后血清基质金属蛋白酶-2及-9水平变化及临床意义

目的探讨冠心病患者缺血再灌注治疗后血清基质金属蛋白酶(matrix metalloproteinase,MMP)-2及MMP-9水平变化及其意义。方法 35例急性心肌梗死急诊行经皮冠状动脉介入术患者(A组)、35例择期经皮冠状动脉介入术患者(B组)及32例行冠状动脉造影术除外冠心病患者为对照组(C组),采用酶联免疫吸附法测定术前1d、术后1,3,5d血清MMP-2及MMP-9水平。结果术前1d,A组血清MMP-2与MMP-9水平高于B组,B组高于C组,差异均有统计学意义(P<0.05);C组术后1,3,5d血清MMP-2及MMP-9水平与术前比较差异无统计学意义(P>0.05),A,B组术后1d与3d血清MMP-2及MMP-9水平明显高于术前(P<0.05),术后5d与术前比较差异无统计学意义(P>0.05)。结论血清MMP-2及MMP-9表达水平增高可能是心肌缺血再灌注损伤的机制之一,有可能成为经皮冠状动脉介入术后评价心肌缺血再灌注损伤严重程度的较好预测因子。

Changes and clinical significance of serum matrix metalloproteinase-2 and-9 levels in patients with coronary artery disease after ischemia reperfusion therapy

Objective To investigate the changes and clinical significance of serum matrix metalloproteinase(MMP)-2 and MMP-9 levels in patients with coronary artery disease after ischemia reperfusion therapy.Methods The levels of serum MMP-2 and MMP-9 were measured in 35 patients with acute myocardial infarction(AMI) receiving emergent PCI(group A),35 patients with AMI receiving delayed PCI(group B),and 32 patients with normal coronary artery(group C) with enzyme linked immunosorbent assay one day before operation and by day 1,3 and 5 d after operation.Results The levels of serum MMP-2 and MMP-9 were higher in group A than those in group B,and higher in group B than those in group C,which showed significant differences(P<0.05).There was no significant difference in the levels of serum MMP-2 and MMP-9 by day 1,3 and 5 after operation compared with before operation in group C(P>0.05).The levels of serum MMP-2 and MMP-9 were obviously higher by day 1 and 3 after operation compared with before operation in group A and B,and there was no significant difference in levels of serum MMP-2 and MMP-9 by day 5 after operation compared with before operation(P>0.05).Conclusion The increasing of serum MMP-2 and MMP-9 expression levels may be one of the mechanisms of myocardial ischemia-reperfusion injury.MMP-2 and MMP-9 may become good evaluable predictors of myocardial ischemia-reperfusion injury after PCI.