急性冠脉综合征患者lppla2与mmp9血浆水平及临床意义-plasma levels of lpp la 2 and m mp9 in patients with acute coronary syndrome and its clinical significance.docx
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急性冠脉综合征患者lppla2与mmp9血浆水平及临床意义-plasma levels of lpp la 2 and m mp9 in patients with acute coronary syndrome and its clinical significance
中文摘要目的 探索脂蛋白相关磷脂酶 A2(LP-PLA2)与基质金属蛋白酶-9(MMP-9) 的血浆水平在预测急性冠脉综合征高危人群的临床价值,以及冠状动脉支架术 对其血浆水平的影响。方法研究对象包括对照组:即经冠脉造影证实无冠脉狭窄者 28 例、急性冠 状动脉综 合征(acute coronary syndrome ,ACS) 患者 27 例 、稳定型心 绞痛 (stable angina pectoris,SAP) 患者 28 例。所有研究对象入院时抽取血液标 本,肝素抗凝后离心分离血浆,采用酶联免疫吸附试验(ELISA)方法检测血浆 中的 LP-PLA2 和 MMP-9 的表达水平,ACS 患者除入院时采集血液标本外,还于 冠脉介入治疗术后 1 月再采集血液标本,肝素抗凝后离心分离血浆,采用酶联 免疫吸附试验(ELISA)方法检测血浆中的 LP-PLA2 和 MMP-9 的表达水平。 结果1、 急性 冠脉 综合 征 组患 者 LP-PLA2 血 浆水 平高 于稳 定 性心 绞痛 组(706.00±149.91ng/ml vs 427.75±44.58ng/ml,P0.001)和对照组(706.00±149.91ng/ml vs 267.69±92.67ng/ml,P0.001),同样急性冠脉综合征组 患 者 MMP-9 血 浆 水 平 高 于 稳 定 性 心 绞 痛 组 ( 7.06 ± 6.22ng/ml vs 2.45 ± 1.23ng/ml, P0.001) 和对 照组 ( 7.06±6.22ng/ml vs 1.84±0.46ng/ml, P0.001);2、在 ACS 组中,冠脉支架术后 1 月患者 LP-PLA2 和 MMP-9 血浆水 平较术前明显降低(706.00±149.91ng/ml vs 520.00±30.36 ng/ml;7.06± 6.22ng/ml vs 2.52±1.54 ng/ml,均 P0.001);3、ACS 患者组中血浆 LP-PLA2 与 MMP-9 水平呈正相关性(r=0.018,F=6.032,P0.05)。结论(1)冠心病患者尤其是急性冠脉综合征患者血浆LP-PLA2和MMP-9水平 升高,提示LP-PLA2和MMP-9作为炎症因子与冠心病的发生发展相关;(2)急性冠 脉综合征患者血浆中的LP-PLA2和MMP-9水平有显著相关,提示二者可以联合作为 ACS的生物标记物;(3)ACS患者PCI术后LP-PLA2和MMP-9下降,提示ACS患者经积 极冠脉PCI治疗后,冠脉病变趋于稳定。关键词脂蛋白相关磷脂酶-A2;基质金属蛋白酶-9;急性冠脉综合征; 经 皮冠脉介入治疗ObjectiveABSTRACTTo explore the stability value of plasma of lipoprotein-associatedphospholipaseA2 ( LP-PLA2) and Matrix Metalloproteinases-9(MMP-9) in predicting people sufferer acute coronary syndrome, as well as how the percutaneous transluminal coronary intervention(PCI) affecting the plasma level.MethodsResearch objects include comparison groups: proved by coronal artery angiography that no sufferring Coronary Artery Stenosis, 28 cases; Acute Cornary Syndrome (ACS) sufferer, 27 cases; stable angina pectoris(SAP) sufferer 28 cases. All research objects were collected blood samples when hospitalized, after heparin, we use centrifugal separater to separate the plasma, here we adopt the ELISA testing to collect plasma express level of LP-PLA2 and MMP-9, ACS sufferer under PCI for a month will collect blood sample again apart from the first time,
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