急性冠状动脉综合征患者外周血中脂联素水平与基质金属蛋白酶-9及其组织抑制因子-1关系的探讨

目的:探讨急性冠状动脉综合征患者(ACS)外周血中脂联素与基质金属蛋白酶-9(MMP-9)及基质金属蛋白酶组织抑制因子-1(TIMP-1)水平及其相关性的研究。方法:急性心肌梗死组19例,不稳定性心绞痛组31例,稳定性心绞痛组13例,正常对照组22例,检测各组外周血中脂联素、MMP-9、TIMP-1的浓度。各组间采用独立样本的t检验,各参数之间进行单因素的相关分析。结果:急性心肌梗死组、不稳定性心绞痛组分别与正常对照组比较:外周血清中脂联素的浓度、TIMP-1的浓度均显著降低(P<0.05～0.01),MMP-9/TIMP-1及MMP-9的浓度则均显著升高(P<0.05～0.01);急性心肌梗死组、不稳定性心绞痛组与稳定性心绞痛组比较,脂联素的浓度显著降低(P<0.05～0.01),MMP-9/TIMP-1升高(P<0.05～0.01);稳定性心绞痛组与正常对照组比较各指标间无明显差异。相关性分析中:脂联素与MMP-9之间无相关性(r=-0.248,P>0.05),脂联素与TIMP-1有显著相关性(r=0.408,P<0.01),脂联素与MMP-9/TIMP-1之间有显著相关性(r=-0.478,P<0.001)。结论:ACS患者中,脂联素的分泌减少,导致TIMP-1的分泌也减少,MMP-9/TIMP-1平衡破坏,可能是急性冠状动脉综合征发生的重要因素。

Relationship Between MMP-9/TIMP-1 and Adiponectin in Peripheral Blood in Patient With Acute Coronary Syndrome

Objective: To study the changes of matrix metalloproteinase-9(MMP-9)/tissue inhibitors of metalloproteinase-1 (TIMP-1)and adiponectin in peripheral blood in patients with acute coronary syndrome (ACS) and explore the relationship between them. Methods: Patients with AMI(n=19), unstable angina (n=31),stable angina(n=13) and healthy control group (n=22) were included in this study. All the results were obtained by ABC-ELISA and analysed by independent t-test and correlation analysis. Results: In groups of AMI and UA, the levels of TIMP-1 and adiponectin in peripheral blood were significantly decreased compared with the healthy control group (P<0.05-0.01),but MMP-9 level and MMP-9/TIMP-1 value were significantly increased (P <0.05-0.01). Adiponectin was obviously decreased (P<0.05-0.01) and MMP-9/TIMP-1 was relatively increased (P<0.01,p>0.05)in AMI and UA groups compared with the SA group. Between the SA group and the healthy control group there were no obvious difference. The concentration of adiponectin was significantly positively correlated with TIMP-1(r=0.408, P<0.01) and significantly negatively correlated with MMP-9/TIMP-1(r=0.478, P<0.001). Conclusion: The decreased adiponectin affects the stabilization of plaque in coronary artery,and its relation with MMP-9/TIMP-1 may be an important factor in the occurence of ACS.