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|本期目录/Table of Contents|

MMPs与早期行PCI的NSTEMI患者左室重构相关

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2011年第2期
页码:
214-217
栏目:
临床研究
出版日期:
2010-12-10

文章信息/Info

Title:
Relationship between matrix metalloproteinase changes and non-ST-elevation myocardial infarction patients treated with early percutaneous coronary intervention
作者:
王守力1; 孙飞2; 陈力量3; 冯国斌4; 金菲菲5; 闫承慧1; 韩雅玲1
1.沈阳军区总医院心内科，辽宁 沈阳 110016；2.沈阳军区大连210医院心内科，辽宁 大连 116021；3.安徽医科大学附属安庆医院老年病科，安徽 安庆 246001；4.泗阳县人民医院心内科，江苏 泗阳 234300；5.辽宁医学院研究生院，辽宁 沈阳 121001
Author(s):
WANG Shou-li1;  SUN Fei2;  CHEN Li-liang3;  FENG Guo-bin4;  JIN Fei-fei5;  Yan Cheng-hui1;  HAN Ya-ling1
Department of Cardiology, General Hospital, Shenyang Military Area Command, Shenyang 110016, Liaoning, China
关键词:
心肌梗死; 非ST段抬高型; 左心室重构; 金属基质蛋白酶
Keywords:
non-ST-elevation myocardial infarction;  left ventricular remodeling;  matrix metalloproteinases
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的: 探讨早期行冠状动脉介入治疗（PCI）的非ST段抬高型心肌梗死（NSTEMI）患者血浆中金属基质蛋白酶（MMPs）的时间变化规律及与心肌梗死（MI）后左心室重构的相关性。方法: 成功随访12个月的早期行PCI的NSTEMI患者126例，于入院即刻、发病后2 d、4 d、2周、4周抽取外周静脉血，ELISA检测血浆中MMP-2和MMP-9的浓度。PCI术后患者临床随访12个月，对比入院时及术后12个月心脏超声图，分析左室舒张末期容积（LVEDV）和左室射血分数（LVEF）的变化及与MMPs的相关关系。结果: ① MI后2周的时间内，血浆中MMP-2的浓度随着MI时间的延长而不断升高，其后MMP-2的浓度开始下降；MMP-9的浓度在MI后4 d时达到最高，其后MMP-9浓度开始明显下降。②同入院时相比，MI后12个月后LVEDV明显扩大，完成随访的患者LVEDV扩大(11±4) ml。LVEF明显降低，降低(9±3)%。 MI后2 d时的MMP-9的浓度与ΔLVEDV呈正相关，与ΔLVEF的相关关系不明显。4 d时的MMP-9值与12个月后的ΔLVEDV和ΔLVEF呈正相关；MI后2周和4周MMP-2的浓度与12个月后的ΔLVEDV和ΔLVEF呈正相关。结论: NSTEMI患者MI后4 d的MMP-9和2周的MMP-2浓度与短期内左心室重构及左心室功能具有明显相关性。
Abstract:
AIM: To study the time-related changes of matrix metalloproteinases (MMPs) and the relationship between MMPs and left ventricular (LV) remodeling in patients with non-ST-elevation myocardial infarction (NSTEMI) treated with early percutaneous coronary intervention (PCI). METHODS: A 12-month follow-up was conducted in 126 NSTEMI patients treated with early PCI. Plasma MMP-2 and MMP-9 were assayed at intervals (2 days, 4 days, 2 weeks and 4 weeks) in NSTEMI patients. The serial changes of LVEDV and LVEF were measured by echocardiography at baseline and 12 months, and the relationship between MMP-2, -9 and LVEDV and LVEF after NSTEMI was analyzed. RESULTS: MMP-2 concentrations substantially increased throughout the post-MI 2 weeks and then began to drop. MMP-9 concentration increased at 2 and 4 days after MI and dropped subsequently. MMP-9 concentration at 2 days after MI was positively correlated with ΔLVEDV (r＝0.350, P=0.028) and MMP-9 concentration at 4 days after MI was positively correlated with ΔLVEDV (r＝0.402, P=0.000) and ΔLVEF (r＝0.333, P=0.040). MMP-2 concentrations at 2 weeks and 4 weeks after MI were positively correlated with ΔLVEDV (2 weeks, r＝0.378, P=0.010; 4 weeks, r＝0.331, P=0.041) and ΔLVEF (2 weeks, r＝0.501, P=0.000; 4 weeks, r＝0.367, P=0.014). CONCLUSIONS: Plasma MMP-9 concentrations at 4 days after NSTEMI and MMP-2 concentrations at 2 weeks and 4 weeks after NSTEMI are correlated with LV remodeling.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2010-04-07.基金项目：辽宁省自然科学基金资助项目（20082074） 通讯作者：韩雅玲，主任医师，主要从事冠心病介入治疗基础与临床研究Email:hanyl@medmail.com.cn 作者简介：王守力，主任医师，博士Email:wangsl.63@126.com
更新日期/Last Update: 2010-12-10