CAJ | 학술논문

目的:观察不同类型冠心病患者的血浆脑钠肽(BNP)和基质金属蛋白酶9 (MMP-9)、基质金属蛋白酶组织抑制因子-1(TIMP-1)及超敏C反应蛋白(hsCRP)水平的变化,探讨其临床意义.方法:113例均经冠状动脉造影确诊的冠心病(CHD)患者,按临床类型分为:急性心肌梗死(AMI)组36例,不稳定型心绞痛(UAP)组46例,稳定型心绞痛(SAP)组31例;另选30例非CHD者作对照组.分别采用化学发光法、ELISA及透射比浊法检测入院次日血浆BNP、MMP-9、TIMP-1及hsCRP的水平.结果:AMI组、UAP组、SAP组和对照组血浆BNP水平分别为(656.80±351.49)、(216.23±144.42)、(57.17±36.77)、(39.57±30.21)ng/L;MMP-9水平分别为(242.57±69.62)、(166.29±58.47)、(69.31±18.39)、(64.56±16.49)μg/L;TIMP-1水平分别为(196.83±56.57)、(159.23±45.41)、(83.69±14.31)、(81.95±13.28)μg/L;MMP-9/TIMP-1比值水平分别为1.30±0.39、1.06±0.32、0.82±0.14、0.80±0.22;hsCRP水平分别为(23.08±5.19)、(13.80±2.51)、(4.92±2.98)、(3.94±2.33)mg/L.AMI组血浆BNP、MMP-9、TIMP-1、MMP-9/TIMP-1及hsCRP水平明显高于UAP组(P<0.05),UAP组各项指标明显高于SAP组和对照组(P<0.05),SAP组与对照组各项指标水平比较差异无统计学意义(P>0.05).BNP与hsCRP、MMP-9水平变化呈正相关,与左室射血分数呈负相关.结论:不同临床类型CHD患者的血浆BNP、MMP-9、TIMP-1、MMP-9/TIMP-1及hsCRP水平不同,提示上述指标对CHD患者进行危险分层及分析预后有一定临床价值.
목적:관찰불동류형관심병환자적혈장뇌납태(BNP)화기질금속단백매9 (MMP-9)、기질금속단백매조직억제인자-1(TIMP-1)급초민C반응단백(hsCRP)수평적변화,탐토기림상의의.방법:113례균경관상동맥조영학진적관심병(CHD)환자,안림상류형분위:급성심기경사(AMI)조36례,불은정형심교통(UAP)조46례,은정형심교통(SAP)조31례;령선30례비CHD자작대조조.분별채용화학발광법、ELISA급투사비탁법검측입원차일혈장BNP、MMP-9、TIMP-1급hsCRP적수평.결과:AMI조、UAP조、SAP조화대조조혈장BNP수평분별위(656.80±351.49)、(216.23±144.42)、(57.17±36.77)、(39.57±30.21)ng/L;MMP-9수평분별위(242.57±69.62)、(166.29±58.47)、(69.31±18.39)、(64.56±16.49)μg/L;TIMP-1수평분별위(196.83±56.57)、(159.23±45.41)、(83.69±14.31)、(81.95±13.28)μg/L;MMP-9/TIMP-1비치수평분별위1.30±0.39、1.06±0.32、0.82±0.14、0.80±0.22;hsCRP수평분별위(23.08±5.19)、(13.80±2.51)、(4.92±2.98)、(3.94±2.33)mg/L.AMI조혈장BNP、MMP-9、TIMP-1、MMP-9/TIMP-1급hsCRP수평명현고우UAP조(P<0.05),UAP조각항지표명현고우SAP조화대조조(P<0.05),SAP조여대조조각항지표수평비교차이무통계학의의(P>0.05).BNP여hsCRP、MMP-9수평변화정정상관,여좌실사혈분수정부상관.결론:불동림상류형CHD환자적혈장BNP、MMP-9、TIMP-1、MMP-9/TIMP-1급hsCRP수평불동,제시상술지표대CHD환자진행위험분층급분석예후유일정림상개치.
Objective:To observed the changes of plasma levels of BNP, MMP-9,TIMP-1 and hsCRP in patients with different types of coronary heart disease and investigate its clinical value. Method:The total of 113 patients with CHD diagnosed by selected coronary angioplasty were enrolled in this study, including 36 cases of acute myocardial infarction(AMI),46 cases of unstable angina(UAP) and 31 cases of stable angina(SA). And 30 persons without CHD were selected as the control. Plasma levels of BNP, MMP-9, TIMP-1 and hsCRP were detected by the methods of chemoluminescence, ELISA and turbidimetry, respectively. Result:Plasma BNP levels of AMI, UAP, SAP and control group were (656.80±351.49), (216.23±144.42),(57.17±36.77) and (39.57±30.21)ng/L, respectively. Plasma MMP-9 levels of AMI, UAP, SAP and control group were (242.57±69.62), (166.29±58.47), (69.31±18.39) and( 64.56±16.49)μg/L, respectively. Plasma TIMP-1 levels of AMI, UAP, SAP and control group were (196.83±56.57), (159.23±45.41), (83.69±14.31) and (81.95±13.28)μg/L, respectively. Ratios of MMP-9/TIMP-1 were 1.30±0.39, 1.06±0.32, 0.82±0.14 and 0.80±0.22, respectively. Plasma hsCRP levels were (23.08±5.19), (13.80±2.51), (4.92±2.98) and (3.94±2.33)mg/L, respectively. Plasma levels of BNP, MMP-9, TIMP-1, MMP-9/TIMP-1 and hsCRP in AMI group were obviously higher than those in UAP group (P<0.05). Au makers in UAP group were obviously higher than those in SAP group(P<0.05).There was no significant differences of these markers between SAP group and control group. Plasma BNP levels were positively correlated with plasma hsCRP and MMP-9 levels and negatively correlated with LVEF. Conclusion:Plasma levels of BNP, MMP-9, TIMP-1 and hsCRP are associated with different clinical phenotyes of CHD. Those markers may be helpful to the risk-stratification and prognosis of CHD.