冠状动脉粥样硬化斑块形态及介入治疗与MMP-9的关系

山东大学学报(医学版)

冠状动脉粥样硬化斑块形态及介入治疗与MMP-9的关系

姜红菊¹，李润智¹，王营¹，徐冬梅²，张梅³，张运³，李继福³

1. 山东中医药大学第二附属医院心血管内科，济南 250001；
2. 济南市第三人民医院心血管内科，济南 250101；
3. 山东大学齐鲁医院心血管内科，济南 250012

收稿日期:2008-05-26 修回日期:1900-01-01 出版日期:2008-10-16 发布日期:2008-10-16
通讯作者: 姜红菊

Relationship between the plasma level of matrix metalloproteinase-9 and structural characteristics of plaques and percutaneous coronary intervention

JIANG Hong-ju¹,　LI Run-zhi¹,　 WANG Ying¹,　XU Dong-mei²,　ZHANG Mei³,　ZHANG Yun³,　LI Ji-fu³

1. Department of Cardiovascular, Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine，
Jinan 250001, China; 2. Department of Cardiovascular, Jinan Third Hospital, Jinan 250101, China;
3. Department of Cardiovascular, Qilu Hospital of Shandong University, Jinan 250012, China

Received:2008-05-26 Revised:1900-01-01 Online:2008-10-16 Published:2008-10-16
Contact: jianghongju@medmail.com.cn

摘要/Abstract

摘要： 目的探讨急性冠脉综合征（ACS）及稳定型心绞痛（SA）患者外周血基质金属蛋白酶-9(MMP-9）、巨噬细胞集落刺激因子(M-SCF)、C反应蛋白（CRP)的水平与斑块形态特征的关系以及介入治疗后的变化。方法62例患者分为ACS组35例，SA组27例。分别采用速率散射光比浊法和酶联免疫吸附法检测所有患者介入治疗前后外周血MMP-9、M-SCF、CRP的浓度。根据冠脉造影斑块形态特征将冠脉斑块分为Ⅰ、Ⅱ、Ⅲ型。根据超声特点将颈动脉斑块分为易损型和稳定型，比较ACS、SA患者斑块的型别及介入治疗前后MMP-9、M-SCF、CRP水平的变化。结果① 介入治疗前ACS组患者MMP-9、M-SCF、CRP水平高于SA组（P＜0.05)；②ACS和SA患者介入治疗前后MMP-9、M-SCF、CRP水平差异有统计学意义（P＜0.05)；③ACS组患者冠脉斑块主要为Ⅱ型，颈动脉斑块主要为易损斑块，SA患者则冠脉斑块主要为Ⅰ、Ⅲ型，颈动脉斑块主要为稳定斑块；④不同斑块类型MMP-9、M-SCF、CRP浓度不同，冠脉斑块Ⅱ型较Ⅰ、Ⅲ型显著升高（P＜0.05)，颈动脉斑块中易损斑块较稳定斑块显著升高（P＜0.05)。结论外周血MMP-9、M-SCF、CRP的水平和斑块特征与斑块的稳定性有关，对于冠脉事件有一定的预示作用。

关键词: 巨噬细胞集落刺激因子, 动脉硬化, C反应蛋白, 血管成形术, 支架植入术, 基质金属蛋白酶

Abstract: To explore the plasma levels of MMP-9, M-SCF and CRP of patients with ACS and SA before and after percutaneous coronary intervention, so as to quantify the relation between structural characteristics of plaque and plasma levels of MMP-9, M-SCF and CRP. Methods35 patients with acute coronary syndrome and 27 patients with stable angina were enrolled in this study. Serum MMP-9, M-SCF and CRP levels were determined by the speed diffused light turbidimetric method and by enzyme association immunity adsorption law before and after percutaneous coronary intervention. Based on coronary angiography plaque morphology, the patch was typed as Ⅰ, Ⅱ and Ⅲ and based on ultrasound for the carotid artery, plaque was typed as stable and unstable plaques. Results ① Serum MMP-9, M-SCF and CRP levels were significantly higher in the ACS group than those in the SA group（P＜0.05). ② MMP-9, M-SCF and CRP levels were significantly different in the ACS and SA patients before and after intervention treatments（P＜0.05). ③ The majority of the coronary plaque of the ACS group was type Ⅱ and of the carotid artery plaque was vulnerable, which were significantly different from those of the SA group（P＜0.05). Conclusion Levels of MMP-9, M-SCF and CRP are related to plaque structural characteristics and plaque stability.

Key words: Matrix metalloproteinase-9, Percutaneous transluminal coronary angioplasty, Stent implantation, Atherosclerosis, C-reactive protein, Macrophage colonystimulating factor

中图分类号:

R541.4

姜红菊,李润智,王营,徐冬梅,张梅,张运,李继福 . 冠状动脉粥样硬化斑块形态及介入治疗与MMP-9的关系[J]. 山东大学学报(医学版), 2008, 46(10): 966-970.

JIANG Hong-ju,LI Run-zhi, WANG Ying,XU Dong-mei,ZHANG Mei,ZHANG Yun,LI Ji-fu. Relationship between the plasma level of matrix metalloproteinase-9 and structural characteristics of plaques and percutaneous coronary intervention [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2008, 46(10): 966-970.

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