冠心病患者外周血细胞外基质金属蛋白酶诱导因子表达量与斑块特征相关性分析

目的分析冠状动脉粥样硬化性心脏病(冠心病)患者外周血细胞外基质金属蛋白酶诱导因子(EMMPRIN)表达量与斑块特征的相关性。方法选取2017年6月至2019年6月于山东第一医科大学附属济南人民医院心内科就诊的急性冠脉综合征患者(ACS组)82例和稳定型心绞痛患者(SAP组)57例作为研究对象,另选取同期于体检的健康体检者60例作为对照组(CON组)。比较3组外周血EMMPRIN表达水平的差异,使用冠状动脉(冠脉)CT成像和光学相关断层扫描(OCT)评估斑块特性,分析EMMPRIN水平与斑块特征的相关性。结果ACS组和SAP组患者外周血EMMPRIN表达水平明显高于CON组,且ACS组明显高于SAP组(P均<0.05)。冠脉CT成像显示,ACS组患者病变血管处软斑块最多(56.10%),纤维斑块(25.61%)和硬化斑块(18.29%)较少;SAP组患者病变血管处钙化斑块最多(52.63%),软斑块(17.54%)和纤维斑块(29.82%)较少。OCT结果显示,ACS组斑块破裂、血栓及脂质弧明显高于SAP组,而斑块纤维帽厚度明显低于SAP组(P均<0.05)。软斑块患者外周血EMMPRIN表达水平明显高于纤维斑块和钙化斑块患者,且纤维斑块患者高于钙化斑块患者(P均<0.05)。相关性分析显示,患者外周血EMMPRIN表达水平与斑块稳定程度及斑块纤维帽厚度呈明显的负相关,与斑块脂质弧呈明显的正相关(P均<0.05)。结论冠心病患者外周血EMMPRIN表达水平明显升高,且与斑块稳定性下降密切相关,其可对冠心病的早期诊断及预防提供帮助。

Correlation between expression of extracellular matrix metalloproteinase induce in peripheral blood and plaque characteristics in patients with coronary heart disease

Objective To analyze the correlation between expression of extracellular matrix metalloproteinase inducer(EMMPRIN)in peripheral blood and plaque characteristics in patients with coronary heart disease(CHD).Methods The patients with acute coronary syndrome(ACS group,n=82)and patients with stable angina pectoris(SAP group,n=57)were chosen from Department of Cardiology in Jinan People’s Hospital affiliated to Shandong First Medical University from June 2017 to June 2019.Meanwhile the healthy controls(CON group,n=60)were chosen from the same hospital.The expression level of EMMPRIN was compared among 3 groups.The plaque characteristics were reviewed by using coronary artery CT imaging and optical coherence tomography(OCT).The correlation between EMMPRIN expression level and plaque characteristics was analyzed.Results The expression level of EMMPRIN was significantly higher in ACS group and SAP group than that in CON group,and was significantly higher in ACS group than that in SAP group(all P<0.05).The results of coronary artery CT imaging showed that there were more soft plaques(56.10%)and less fibrous plaques(25.61%)and atherosclerotic plaques(18.29%)in lesion vessels in ACS group,and there were more calcified plaques(52.63%)and less soft plaques(17.54%)and fibrous plaques(29.82%)in SAP group.The results of OCT showed that the incidence of plaque rupture,thrombosis and plaque lipid arc were significantly higher,and thickness of plaque fibrous cap was significantly lower in ACS group than those in SAP group(all P<0.05).The expression level of EMMPRIN was significantly higher in patients with soft plaques than that in patients with fibrous plaques and calcified plaques,and was higher in patients with fibrous plaques than that in patients with calcified plaques(all P<0.05).The results of correlation analysis showed that EMMPRIN expression level was negatively correlated to plaque stability and thickness of plaque fibrous cap,and positively correlated to plaque lipid arc(all P<0.05).Conclusion The expression level of EMMPRIN in peripheral blood increases significantly and is closely correlated to the decrease of plaque stability in CHD patients,which can provide help for the early diagnosis and prevention of CHD.