MMP—2在ST段抬高性心肌梗死中的預(yù)后評(píng)估價(jià)值分析

郭俊林 張立

摘 要：目的 通過研究血漿MMP-2在ST段抬高性心肌梗死患者的表達(dá)，進(jìn)一步分析MMP-2對(duì)近期的主要不良心血管事件的評(píng)估價(jià)值。方法 選取我院2013年9月～2015年9月ST段抬高性心肌梗死患者110例作為實(shí)驗(yàn)組，選取同期身體健康的體檢志愿者50例作為對(duì)照組。用酶聯(lián)免疫吸附試驗(yàn)檢測兩組患者血漿MMP-2濃度，比較兩組男性比例、年齡、BMI、空腹血糖、總膽固醇、血肌酐以及MMP-2水平；通過GFRACE評(píng)分核定實(shí)驗(yàn)組入院GRACE積分，觀察住院期間的MACE發(fā)生情況。結(jié)果 實(shí)驗(yàn)組的男性比例、年齡、空腹血糖、血肌酐以及MMP-2水平均高于對(duì)照組，差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；兩組BMI和總膽固醇水平相比，差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。實(shí)驗(yàn)組患者住院期間累計(jì)發(fā)生MACE共16例（14.55%）；基線入院GRACE評(píng)分、血漿MMP-2水平預(yù)測STEMI患者發(fā)生MACE的AUC分別為0.747（SE=0.069，P=0.006，95%CI 0.597～0.863）、0.721（SE=0.077，P=0.016，95%CI 0.567～0.846）。結(jié)論 MMP-2參與了急性心肌梗死的發(fā)生過程，對(duì)STEMI患者在院期間MACE事件的發(fā)生有一定的評(píng)估價(jià)值。

關(guān)鍵詞：ST段抬高性心肌梗死；基質(zhì)金屬蛋白酶-2；危險(xiǎn)性評(píng)估

中圖分類號(hào)：R542.22 文獻(xiàn)標(biāo)識(shí)碼：A DOI：10.3969/j.issn.1006-1959.2018.17.021

文章編號(hào)：1006-1959（2018）17-0071-04

Abstract：Objective To investigate the value of MMP-2 in the evaluation of recent major adverse cardiovascular events by studying the expression of plasma MMP-2 in patients with ST-segment elevation myocardial infarction.Methods A total of 110 patients with ST-segment elevation myocardial infarction from September 2013 to September 2015 were selected as the experimental group.50 healthy volunteers were selected as the control group.The levels of plasma MMP-2 in the two groups were measured by enzyme-linked immunosorbent assay （ELISA）.The proportion，age，BMI，fasting blood glucose，total cholesterol，serum creatinine and MMP-2 levels of the two groups were compared.The GRACE scores of the experimental group were confirmed by GFRACE score.Observe the occurrence of MACE during hospitalization.Results The male proportion，age，fasting blood glucose，serum creatinine and MMP-2 levels in the experimental group were higher than those in the control group，the difference was statistically significant（P<0.05）.There was no significant difference between the two groups in BMI and total cholesterol levels（P>0.05）.A total of 16 patients（14.55%）had a cumulative MACE during the hospitalization period.Baseline admission GRACE score and plasma MMP-2 level predicted AUC of MACE in STEMI patients were 0.747（SE=0.069，P=0.006，95%CI 0.597～0.863），0.721（SE=0.077，P=0.016，95% CI 0.567～0.846）. Conclusion MMP-2 is involved in the pathogenesis of acute myocardial infarction，and it has certain evaluation value for the occurrence of MACE events in patients with STEMI.

Key words：ST-segment elevation myocardial infarction；Matrix metalloproteinase-2；Risk assessment

心血管疾病的危險(xiǎn)因素除了常見的高血壓、糖尿病、血脂異常之外，慢性炎癥也扮演了重要角色，炎癥反應(yīng)致使動(dòng)脈粥樣硬化的表達(dá)上調(diào)。基質(zhì)金屬蛋白酶-2（matrix metalloproteinase-2，MMP-2）促進(jìn)粥樣斑塊的纖維基質(zhì)逐步降解，導(dǎo)致其穩(wěn)定性明顯下降，最終導(dǎo)致斑塊破裂，進(jìn)而觸發(fā)血栓，在ST段抬高性心肌梗死（ST-segment elevation myocardial infarction，STEMI）的過程中起到重要作用[1-3]。納入了多種臨床因素的急性冠脈事件全球注冊(cè)風(fēng)險(xiǎn)評(píng)分系統(tǒng)（global registry of acute coronary events，GRACE）是目前臨床醫(yī)生評(píng)估STEMI患者預(yù)后的主要評(píng)估工具[4]，本研究通過檢測MMP-2在我院110例STEMI患者外周血中的表達(dá)水平，觀察MMP-2的時(shí)間依耐性變化趨勢(shì)，探討MMP-2對(duì)STEMI預(yù)后的評(píng)估價(jià)值。……