OCT检测冠状动脉斑块特征及其与基质金属蛋白酶相关性研究

目的 采用冠状动脉内光学相干断层扫描(OCT)检测冠状动脉粥样硬化斑块特征及其与血清基质金属蛋白酶(MMP)7、MMP9、MMP12水平的关系.方法 选择2014年10月至2016年3月拟行冠状动脉造影明确冠状动脉病变的患者,根据OCT检测结果分为稳定斑块组和不稳定斑块组.应用OCT检测斑块的纤维帽厚度、脂质池角度、巨噬细胞浸润、斑块裂隙、斑块内新生血管等特征.搜集研究对象基本资料,采用酶联免疫吸附试验(ELISA)检测血清MMP7、MMP9、MMP12水平.结果 (1)稳定斑块组纤维帽厚度大于不稳定斑块组(P＜0.01);不稳定斑块组脂质池角度、巨噬细胞浸润、内膜侵蚀、斑块出现裂隙均多于稳定斑块组(P＜0.05);(2)不稳定斑块组患者MMP7、MMP9水平高于对照组和稳定斑块组(P＜0.05);(3)斑块纤维帽厚度与血清MMP9水平呈明显负相关(r=-0.336,P＜0.05);巨噬细胞浸润组MMP7、MMP9水平大于无巨噬细胞浸润组(P＜0.05);血管内膜有侵蚀组MMP9水平大于无内膜侵蚀组(P＜0.01).结论 OCT检测能够发现不稳定斑块,而血清MMP7、MMP9水平在不稳定斑块病变患者中明显升高,可作为预测不稳定斑块、指导治疗决策的重要依据.

Study on correlation between OCT for detecting characteristics of coronary artery plaque and matrix metalloproteinase

Objective To apply the optical coherence tomography(OCT) to detect the characteristics of coronary artery plaque and to investigate its correlation with levels of serum matrix metalloproteinase 7(MMP 7),MMP9 and MMP12.Methods The patients undergoing coronary arterial angiography for diagnosing coronary arterial lesions in the cardiology department of our hospital from October 2014 to March 2016 were collected and included into the research subjects.The subjects were divided into the stable plaque group and unstable plaque group based on the results of OCT scanning.The neovascularization characteristics such as the fibrous cap thickness of plaque,angle of lipid pool,macrophage infiltration and plaque cracks were detected by using OCT.ELISA was used to measure serum MMP7,MMP9 and MMP12 levels.Results (1) The fibrous cap thickness in the stable plaque group was more than that in the unstable plaque group(P＜0.01);the lipid pool angle,microphage infiltration,intima erosion and plaque cracks in the unstable plaque group were more than those in the stable plaque group(P＜0.05).(2) The MMP7 and MMP9 levels in the unstable plaque group were higher than those in the stable plaque group and control group(P＜0.05).(3) The fibrous cap thickness had significantly negative correlation with serum MMP9 level(r=-0.336,P=0.034);the MMP7 and MMP9 levels in the microphage infiltration group were higher than those in the non-microphage infiltration group(P＜0.05);the MMP9 level in the intima erosion group was higher than that in the non-intima erosion group(P＜0.01).Conclusion OCT can detect and find unstable plaque and the serum levels of MMP7 and MMP9 are significantly elevated in the patients with unstable plaque,which can be used as an important basis for predicting unstable plaque and guiding the treatment decisions.