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目的:探讨急性心肌梗死(AMI)患者基质金属蛋白酶-9(MMP-9)的变化及与心室重构的相关性,并观察缬沙坦对其干预的效果。方法:选AMI患者90例,随机分为常规治疗组和缬沙坦组,正常体检者45例为正常对照组,AMI患者于入选时检测MMP-9,测定超声心动图指标[左室收缩末期容积(LVESV)、舒张末期容积(LVEDV)和左室射血分数(LVEF)],服药1周、4周、12周后再测定MMP-9、超声心动图指标,正常对照组病例入选后测定MMP-9。比较各组病例MMP-9值;比较两治疗组患者用药1周及4周后MMP-9值、用药4周及12周后超声心动图指标及其变化。结果:AMI患者与正常对照组MMP-9值、超声心动图指标比较,差异有统计学意义(P<0.05);用药1周时B组较A组MMP-9值减小(P<0.05);用药4周时A、B两组MMP-9值均减小,而超声心动图指标差异无统计学意义,12周后A、B两组超声心动图指标发生变化(P<0.05);用药1周后、4周后两组MMP-9值均较用药前减小(P<0.05)。结论:缬沙坦能降低AMI患者MMP-9的表达,降低心室重构发生率。
Objective: To investigate the changes of matrix metalloproteinase-9 (MMP-9) and its relationship with ventricular remodeling in patients with acute myocardial infarction (AMI) and to observe the effect of valsartan on it. Methods: 90 AMI patients were randomly divided into routine treatment group and Valsartan group, 45 normal subjects were normal control group, AMI patients were enrolled in the detection of MMP-9, measured echocardiographic parameters [end-systolic (LVESV, LVEDV and LVEF) were measured before and after 1 week, 4 weeks and 12 weeks after treatment. The levels of MMP-9 and echocardiography were measured before and after the treatment in normal control group MMP-9. The MMP-9 levels were compared between the two groups. The echocardiographic parameters and the changes of MMP-9, the 4-week and 12-week after treatment were compared between the two treatment groups. Results: The MMP-9 and echocardiographic parameters in AMI patients were significantly different from those in normal controls (P <0.05) ; At 4 weeks after treatment, the MMP-9 values in both A and B groups decreased, while the echocardiographic parameters had no significant difference. After 12 weeks, the echocardiographic parameters of A and B groups changed (P <0.05) After 1 week, the MMP-9 values of the two groups decreased after 4 weeks (P <0.05). Conclusion: Valsartan can reduce the expression of MMP-9 in patients with AMI and reduce the incidence of ventricular remodeling.