基质金属蛋白酶与高血压心脏病心室重构的关系

目的通过测定高血压病患者血清基质金属蛋白酶-1（MMP-1）、基质蛋白酶抑制剂-1（TIMP-1）浓度，明确基质金属蛋白酶在高血压心脏病心室重构中的作用。方法120例门诊及住院患者，超声心动图测各相关指标，分为四组：健康组32例，高血压组28例，左室肥厚无心衰组26例，左室肥厚心衰组34例。酶联免疫吸附法（ELISA）测定血清MMP-1、TIMP-1浓度。结果健康组与高血压组比较各指标差异无统计学意义（P〉0．05）。高血压组、左室肥厚无心衰组、左室肥厚心衰组三组左室后壁厚度（LVPWT）、左室质量指数（LVMI）、TIMP—1浓度逐渐升高，而血清MMP—1浓度差异无统计学意义。血清TIMP—1浓度与左室重构指标LVMI呈正相关（r=0．54，P〈0．05）。结论正常左室结构和功能的高血压患者血清MMP一1、TIMP-1正常。TIMP—1可能促进了高血压患者心室重构和心肌舒张功能障碍的进程。

Relationship between matrix metalloproteinase and the ventricular remodeling of hypertensive heart disease

Objective To investigate the role of MMPs during ventricular remodeling in hypertensive heart disease. Methods One hundred twenty cases of out - patients and in - patients, were tested all relevant indicators by echocardiography. The subjects were divided into health group （n = 32）, hypertension group （ n = 28）, left ventricular hypertrophy without heart failure group （ n = 26）, left ventricular hypertrophy with heart failure group （n = 34）. The serum of MMP - 1, TIMP - 1 concentrations were detected by ELISA. Results There was no significant difference about all indicators between the health group and the hypertension group （P 〉 0. 05）. The left ventricular posterior wall thickness （LVPWT）, left ventricular mass index （LVMI）, serum TIMP - 1 concentrations increased gradually among hypertension group, left ventricular hypertrophy without heart failure group,left ventricular hypertrophy with heart failure group, while MMP - 1 had no difference among them. Serum TIMI - 1 concentrations had positive correlation with LVMI （r = 0. 54,P 〈 0. 05）. Conclusions Hypertensive patients with normal left ventricular structure and function have normal MMP - 1, TIMI - 1 concentrations. TIMP -1 may promote ventricular remodeling and accelerate the process of the myocardial diastolic dysfunction in hypertensive heart disease.