急性冠脉综合征IL-6与MMP-1的意义及相关性

目的观察急性冠脉综合征（ACS）患者血清炎性介质白介素-6（IL-6）、金属基质蛋白酶-1（MMP-1）水平变化及其相互问的关系。方法将138例入院患者行冠状动脉造影后分为4组，稳定型心绞痛（SA）30例、不稳定型心绞痛（CA）44例、急性心肌梗死（AMI）34例，冠状动脉造影元狭窄为对照组30例。根据冠脉造影结果将ACS分为单支、双支和三支病变。用ELISA法测定患者外周静脉血清IL-6和MMP-1水平；分析各组IL-6和MMP-1水平及冠状动脉狭窄程度与IL-6、MMP-1水平的关系，分析在ACS中IL-6与MMP-1的相关性。结果①各组血清IL-6、MMP-1水平显示，UA组和AMI组明显高于对照组和SA组，且差异有统计学意义（P〈0．01）；UA组与AMI组、对照组与SA组差异无统计学意义（P〉O．05）；两者在单支、双支、三支病变之间差异无统计学意义（P〉0．05）。②在ACS中，IL-6与MMP-1成正相关（r=0．673，P〈0．01）。结论IL-6、MMP-1反映冠脉病变的不稳定性，并不反映冠脉病变狭窄程度，IL-6促进MMP-1释放降解斑块基质引起斑块的不稳定。

Minings of IL-6 and MMP-1 in acute coronary syndrome

Objective To observe the relationship between IL-6,MMP-1 and acute coronary syndromes, and the link between the severity of coronary artery stensis and IL-6, MMP-1. Methods 138 patients who underwent coronary angiography were selected in the study and divided into four groups according to the results of CAG and clinical manifestation：30 patients with SA,44 patients with UA,34 patients with AMI,30 patients as control group whose coronary arteries were normal. ACS group was divided into three groups by the number of stennosised conronary. The serum concentration of IL-6 and MMP-1 in all subjects were measured by ELISA. The relationship between the degree of coronary stenosis and the concentration of IL-6, MMP-1 was analyzed. Results （1）On the one hand, the concentrations of IL-6 and MMP-1 in UA and AMI group were significantly higher than those in control and SA group（P〈0.01 ）. On the other hand, neither IL-6 nor MMP-1 was statistical difference a- mong one-vessel,double-vessel,and three-vessel group （P〉0.05）. （2） IL-6 was positively correlated with MMP-1 in ACS patients（r=0.673 ,P〈0.01 ）. Conclusion Elevated IL-6 and MMP-1 maybe reflect not the degree of coro- nary artery stenosis but the unstability of coronary lesions. MMP-1 capable of degrading matrix components is a novel link between local inflammation in coronary plaques and acute coronary syndromes.