冠状动脉支架植入对冠心病患者血清基质金属蛋白酶2表达的影响

目的研究冠心病患者血清基质金属蛋白酶2浓度与冠状动脉病变程度的关系及冠状动脉支架植入对血清基质金属蛋白酶2浓度的影响。方法将50例冠心病患者分为冠状动脉支架植入组和非冠状动脉支架植入组,统计冠状动脉造影结果,于术前1d,术后1d、10d及30d取静脉血,应用双抗体夹心酶联免疫法检测血清基质金属蛋白酶2浓度的变化。结果非冠状动脉支架植入组手术前后各时间点血清基质金属蛋白酶2浓度差异无显著性(P>0.05);冠状动脉支架植入组手术后基质金属蛋白酶2浓度持续升高(P<0.05)。与术前1d比较,双支病变组基质金属蛋白酶2浓度较单支病变组高,三支病变组比双支病变组高(P<0.05);B型病变组基质金属蛋白酶2浓度比A型病变组高,C型病变组比B型病变组高(P<0.05)。结论冠心病患者冠状动脉病变程度越重血清基质金属蛋白酶2浓度越高,冠状动脉支架植入后30d内基质金属蛋白酶2浓度持续升高。

Effect of Stent Implantation on the Expression of Matrix Metalloproteinase-2 in Patients with Coronary Heart Disease

Aim To explore the effect of percutaneous coronary intervention on the expression of matrix metalloproteinase-2 in the patients with coronary heart disease. Methods Fifty patients with coronary heart disease were selected. There were 25 cases undergoing percutaneous coronary intervention and 25 cases undergoing coronary angiography and bypass graft surgery. Venous blood samples were obtained before and after coronary angiography or 1 day before and l, 10, 30 days after percutaneous coronary intervention. Plasma concentrations of matrix metalloproteinase-2 were determined by enzyme linked immunoassay. Results There were no significant differences in matrix metalloproteinase-2 concentrations of coronary angiography group at each time point (P>0.05). The concentrations of matrix metalloproteinase-2 were significantly increased on days 1, 10, and 30 after percutaneous coronary intervention, and those on day 10 were higher than on 1 day (P<0.05), and on 30 day were higher than on 10 day (P<0.01). The concentrations of matrix metalloproteinase-2 in patients of type B were significantly higher than in patients of type A (P<0.05), and in patients of type C were higher than in patients of type B (P<0.05). The concentrations of matrix metalloproteinase-2 in patients with two diseased vessels were significantly higher than in patients with single diseased vessel (P<0.05), and in patients with three diseased vessels were higher than in patients with two diseased vessels (P<0.05). Conclusions Coronary angiography does not influence matrix metalloproteinase-2 expressions. Stent implantation can lead to increases in matrix metalloproteinase-2. The increases of matrix metalloproteinase-2 are correlated to the degree of coronary stenosis.