急性冠状动脉综合征患者血清同型半胱氨酸脂联素及血清基质金属蛋白酶-9水平与冠状动脉病变关系的研究

目的检测急性冠状动脉综合征(ACS)患者外周血清同型半胱氨酸(HCY)、脂联素(APN)及血清基质金属蛋白酶-9(MMP-9)与冠状动脉病变支数及冠状动脉狭窄程度的相关性。方法选择住我院心内科经冠状动脉造影(CAG)诊断的患者共170例,其中ACS组95例、稳定型心绞痛(SA)组38例和非紫绀先天性心脏病(NCHD)组37例。以酶联免疫吸附测定(ELISA)分别测定患者外周血清HCY、APN及MMP-9水平;冠状动脉病变支数根据CAG评定。结果①ACS组患者外周血清HCY、MMP-9水平均高于NCHD组和SA组患者(P均<0.05);外周血清APN水平ACS组患者均明显低于NCHD组和SA组患者;NCHD组与SA组患者间3项指标比较差异均无统计学意义(P>0.05)。②ACS组患者外周血清HCY、MMP-9水平随冠状动脉病变支数增加而递增,而外周血清APN水平随冠状动脉病变支数增加而递减。结论①HCY、APN及MMP-9水平可能与冠状动脉易损斑块的病理生理相关。②HCY、APN及MMP-9水平的改变可能与冠状动脉粥样硬化发生发展相关。

Serum HCY,MMP-9 and APN are correlated with coronary artery pathological changes in the ACS patients

Objective To detect homocysteine(HCY) and adiponectin(APN) and serum matrix metalloproteinases-9(MMP-9) in patients with acute coronary syndromes and to study their relationship to coronary lesions count and coronary artery stenosis degree.Methods One hundred and seventy patients diagnosed by CAG were enrolled in this study including the ACS group(n=95),SA group(n=38) and NCHD group(n=37).Peripheral blood HCY,APN and MMP-9 level were determined using ELISA;Coronary lesions count was assessed according to CAG.Results ①Peripheral HCY,MMP-9 levels in patients of the ACS groups are higher than those in the NCHD group and SA groups(P<0.05).Peripheral APN level in patients of ACS groups were significantly lower than those in NCHD group and SA group,the differences of three indexes between NCHD group and SA groups are not statistically significant(P>0.05).②Peripheral HCY and MMP-9 level in patients of the ACS groups increases with increasing of coronary lesions count,peripheral APN level in patients of ACS groups decreased with descending of coronary lesions count.Conclusion ①HCY,APN and MMP-9 level may be related to pathophysiology of coronary vulnerable plaques.②HCY,APN and MMP-9 level in the peripheral blood indicates the change of these 3 index may be related to occurrence and development of coronary artherosclerosis.