联合基质金属蛋白酶-9、肌酐清除率及肌钙蛋白T对急性冠脉综合征短期预后的研究

目的:探讨基质金属蛋白酶-9(MMP-9)、肌酐清除率(Ccr)以及联合应用MMP-9、Ccr及肌钙蛋白T(cTnT)在急性冠脉综合征(ACS)短期预后评估中的价值。方法:测定70例ACS患者血清MMP-9、肌酐(Scr)及cTnT,计算Ccr。并对所有患者随访主要不良心脏事件(MACE)6个月。结果:1发生MACE组MMP-9及cTnT水平均高于未发生MACE组,Ccr水平低于未发生MACE组(P均<0.05)。2单因素分析显示MMP-9>26.95ng/ml组随访期MACE发生率明显高于MMP-9≤26.95ng/ml组,Ccr降低组随访期MACE发生率较Ccr正常组显著增高(P<0.05)。多因素分析在校正患者年龄、左室射血分数、高脂血症、高血压、糖尿病等因素后,血清MMP-9及Ccr水平与随访期MACE发生率独立相关。3单因素分析显示MMP-9、Ccr及cTnT均异常组在随访期MACE发生率较三项指标均正常组、三项指标中一项异常组、两项异常组显著性增高(P<0.05)。多因素分析校正患者年龄、左室射血分数、高脂血症、高血压、糖尿病等因素后,MMP-9、Ccr及cTnT均异常与随访期MACE发生率独立相关。结论:MMP-9、Ccr能够作为评价ACS短期预后的指标,MMP-9、Ccr及cTnT三者联合应用对ACS患者住院期间及出院后6个月内发生MACE有更好的预测价值。

Values of the combination use of matrix metalloproteinase-9,creatinine clearance rate and cardiac troponin T in short-term prognosis of acute coronary syndrome

Objective： To evaluate the values of matrix metalloproteinase-9 （MMP-9）, creatinine clearance rate （Ccr） and their combination with cardiac troponin T（cTnT） in short-term prognosis of acute coronary syndrome （ACS）. Method ：Serum MMP 9 ,Ccr and cTnT levels were measured in seventy patients with ACS. The patients were followed up for 6 months and the major adverse cardiovascular events（MACE）were observed and recorded. Results：①The levels of MMP-9 and eTnT were higher in MACE group than those in non- MACE group. MACE group had lower levels of Ccr than non- MACE group（P〈0.05）. ②The incidence of MACE was increased in MMP-9〉26.95 ng/ml group than that in MMP-9≤26. 95 ng/ml group（P〈0.05）. It was significantly higher in the Ccr〈70 ml/min group than that in the Ccr normal group（P〈0.05）. Adjusted for other risk factors, serum levels of MMP-9 and Cer were independent predictor for MACE both during and 6 months after hospitalization. ③The incidence of MACE was significantly higher in MMP-9,Cer and cTnT all abnormal group than those in all of the three indicators normal group, one indicator abnormal group and two indicators abnormal group （P〈0.05）. The combination use of MMP-9,Ccr and cTnT remained an independent predictor for MACE after adiustment for the known clinical risk factors. Conclusion.. MMP-9 and Ccr may predict short-term prognosis in patients with ACS. The combination use of MMP-9,Ccr and cTnT has a higher value in predicting MACE both during and 6 months after hospitalization in patients with ACS.