再灌注治疗对心肌梗死患者血清MMP-1、TIMP-1含量和心室重塑的影响

目的探讨再灌注治疗对急性心肌梗死(AMI)患者心室重塑、心功能、血清基质金属蛋白酶-1(MMP-1)及其组织抑制因子(TIMP-1)的影响。方法对40例AMI患者分别予以常规强化内科保守治疗(常规治疗组,n=20)和在此基础上的急诊再灌注治疗(再灌注组,n=20),分别检测AMI后1周和6个月的左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室射血分数(LVEF)及二尖瓣血流舒张早期流速与心房收缩期流速的比值(VE/VA)及血清MMP-1、TIMP-1含量。结果与常规治疗组同时点亚组比较,再灌注治疗6个月亚组的LVEDD、LVESD及MMP-1均显著降低(P<0.05);两组的LVEF和VE/VA于组间和组内比较差异无显著性(P>0.05);常规治疗6个月亚组和再灌注治疗6个月亚组的TIMP-1均明显低于相应的1周亚组(P<0.05)。结论再灌注可抑制AMI后心室重塑的进展,这可能与其下调MMP-1和T1MP-1表达有关。

Effects of Reperfusion on Ventricular Remodeling,Plasma Matrix Metalloproteinase-1 and Tissue Inhibitor-1 in Patients with Myocardial Infarction

Objective To investigate the effects of reperfusion on ventricular remodeling,function,plasma matrix metalloproteinase-1(MMP-1) and tissue inhibitor-1(TIMP-1) after acute myocardial infarction(AMI) in patients.Methods 40 patients with AMI were divided into conventional therapy group(n=20) and reperfusion group(n=20).The left ventricular end-diastolic dimension(LVEDD),left ventricular end-systolic dimension(LVESD),left ventricular ejection fraction(LVEF) and VE/VA were determine by echocardiography on the 1st week and the 6th month after AMI respectively.ELISA was employed to detect serum level of MMP-1 and TIMP-1 at the same time.Results Compared to the conventional therapy group,LVEDD,LVESD and plasma MMP-1 concentration in reperfusion group at the 6th month were decreased.There were no significant differences in LVEF and VE/VA between the two groups at any time.Serum concentration of TIMP-1 in the group treated with medicine and reperfusion at the 6th month after AMI were significantly lower than those in the same groups at 1st week respectively.Conclusion Reperfusion may inhibit ventricular remodeling subsequent to AMI.It is associated with down regulated expression of MMP-1 and TIMP-1.