王守力, 孙飞, 陈力量, 冯国斌, 金菲菲, 闫承慧, 韩雅玲. MMPs与早期行PCI的NSTEMI患者左室重构相关[J]. 心脏杂志, 2011, 23(2): 214-217.
    引用本文: 王守力, 孙飞, 陈力量, 冯国斌, 金菲菲, 闫承慧, 韩雅玲. MMPs与早期行PCI的NSTEMI患者左室重构相关[J]. 心脏杂志, 2011, 23(2): 214-217.
    Relationship between matrix metalloproteinase changes and non-ST-elevation myocardial infarction patients treated with early percutaneous coronary intervention[J]. Chinese Heart Journal, 2011, 23(2): 214-217.
    Citation: Relationship between matrix metalloproteinase changes and non-ST-elevation myocardial infarction patients treated with early percutaneous coronary intervention[J]. Chinese Heart Journal, 2011, 23(2): 214-217.

    MMPs与早期行PCI的NSTEMI患者左室重构相关

    Relationship between matrix metalloproteinase changes and non-ST-elevation myocardial infarction patients treated with early percutaneous coronary intervention

    • 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.

       

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