CAJ | 학술논문

目的：探讨基质金属蛋白酶-9（ MMP-9）及其抑制剂（ TIMP-1）与高血压颈动脉斑块粥样硬化及其稳定性的关系。方法采用彩色多普勒超声测定125例高血压患者颈动脉内膜中层厚度（ IMT ），根据彩超诊断结果将患者分为单纯高血压组45例，轻度粥样硬化组42例及重度粥样硬化组38例；根据粥样硬化患者的斑块稳定性分为稳定斑块组45例，不稳定斑块35例。另选取50例非粥样硬化的体检健康者为对照组。采用全自动生化分析仪测定各组血清MMP-9、TIMP-1及超敏C反应蛋白（hs-CRP）水平。结果与对照组比较，高血压组MMP-9、hs-CRP水平显著升高，而TIMP-1水平显著下降（P均＜0．05）。重度粥样硬化组MMP-9、hs-CRP水平高于单纯高血压组及轻度粥样硬化组，而TIMP-1水平低于单纯高血压组及轻度粥样硬化组（P均＜0．05）。与稳定斑块组比较，不稳定斑块组MMP-9、hs-CRP水平显著升高，而TIMP-1水平显著下降（P＜0．05）。 logistic多因素回归分析显示，IMT、MMP-9、TIMP-1是高血压颈动脉斑块粥样硬化的独立危险因素。结论血清MMP-9、TIMP-1水平与高血压颈动脉斑块形成及其稳定性关系密切。
목적：탐토기질금속단백매-9（ MMP-9）급기억제제（ TIMP-1）여고혈압경동맥반괴죽양경화급기은정성적관계。방법채용채색다보륵초성측정125례고혈압환자경동맥내막중층후도（ IMT ），근거채초진단결과장환자분위단순고혈압조45례，경도죽양경화조42례급중도죽양경화조38례；근거죽양경화환자적반괴은정성분위은정반괴조45례，불은정반괴35례。령선취50례비죽양경화적체검건강자위대조조。채용전자동생화분석의측정각조혈청MMP-9、TIMP-1급초민C반응단백（hs-CRP）수평。결과여대조조비교，고혈압조MMP-9、hs-CRP수평현저승고，이TIMP-1수평현저하강（P균＜0．05）。중도죽양경화조MMP-9、hs-CRP수평고우단순고혈압조급경도죽양경화조，이TIMP-1수평저우단순고혈압조급경도죽양경화조（P균＜0．05）。여은정반괴조비교，불은정반괴조MMP-9、hs-CRP수평현저승고，이TIMP-1수평현저하강（P＜0．05）。 logistic다인소회귀분석현시，IMT、MMP-9、TIMP-1시고혈압경동맥반괴죽양경화적독립위험인소。결론혈청MMP-9、TIMP-1수평여고혈압경동맥반괴형성급기은정성관계밀절。
Objective To investigate the relationship of matrix metalloproteinase 9(MMP-9) and tissue inhibitor of metalloproteinase 1( TIMP-1) with hypertensive carotid atherosclerosis and its stability .Methods The intima-media thickness(IMT) was measured by using color Doppler ultrasound in 125 cases of hypertension .These patients were divided into simple hypertensive group(n=45),mild atherosclerosis group(n=42) and severe atherosclerosis group(n=38) according to the results of the ultrasound diagnosis.Based on the stability of plaque in atherosclerosis patients,they were classified into stable plaque group(n=45) and unstable plaque group(n=35).Fifty healthy cases without atherosclerosis were selected as control group.The levels of serum MMP-9,TIMP-1 and high-sensitivity C-reactive protein ( hs-CRP) were detected with automatic biochemical analyzer .Results The levels of MMP-9 and hs-CRP increased significantly while the level of TIMP-1 decreased remarkably in the simple hypertension group compared with the controls ( all P <0 .05 ) .The levels of MMP -9 and hs-CRP were significant higher while the level of TIMP-1 was significantly lower in the severe atherosclerosis group in contrast with those in the simple hypertension group and mild atherosclerosis group (P<0.05). The levels of MMP-9 and hs-CRP increased significantly ,but the levels of TIMP-1 decreased significantly in the unstable plaque group compared with stable plaque group (P<0.05).Multivariate logistic regression analysis showed that IMT , MMP-9,TIMP-1 were the independent risk factors for hypertensive carotid atherosclerosis .Conclusion The levels of serum MMP-9 and TIMP-1 closely correlate with the formation and stability of hypertensive carotid plaque .