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目的:探讨N末端脑钠肽(NT-proBNP)及基质金属蛋白酶-9(MMP-9)在判断非ST段抬高急性冠脉综合征早期心室重构中的作用及相互关系。方法:选择连续住院的非ST段抬高急性冠脉综合征患者57例,分为高危组(n=17)、中危组(n=15)及低危组(n=25),并设正常对照组(n=29)。冠状动脉造影前抽取股动脉血,测定NT-proBNP及MMP-9浓度。分别于造影前后3天内及造影后10～14天内行超声心动图检查。结果:各组间NT-proBNP、MMP-9水平及射血分数、左心室质量指数(LVMI)差异具有统计学意义(除射血分数在中危组和低危组之间P>0.05外,其余P均<0.05)。在高危组,NT-proBNP与MMP-9呈正相关(r=0.574,P=0.025),NT-proBNP与LVMI呈正相关(r=0.617,P=0.014);MMP-9与射血分数呈负相关(r=-0.542,P=0.025)。结论:联合检测NT-proBNP及MMP-9对判定高危非ST段抬高急性冠脉综合征早期心室重构具有重要意义。
Objective: To investigate the role and correlation of N-terminal pro brain natriuretic peptide (NT-proBNP) and matrix metalloproteinase-9 (MMP-9) in early ventricular remodeling in non-ST segment elevation acute coronary syndromes. Methods: Fifty-seven consecutive patients with non-ST segment elevation acute coronary syndrome who were hospitalized were divided into high-risk group (n = 17), intermediate risk group (n = 15) and low risk group (n = 25) Normal control group (n = 29). Femoral artery blood was drawn before coronary angiography, and the concentrations of NT-proBNP and MMP-9 were measured. Echocardiography was performed within 3 days before and after angiography and within 10 to 14 days after angiography. Results: The levels of NT-proBNP, MMP-9, ejection fraction and left ventricular mass index (LVMI) in each group had statistical significance (except for ejection fraction, P> 0.05, The remaining P <0.05). There was a positive correlation between NT-proBNP and MMP-9 (r = 0.574, P = 0.025) and LVMI in high risk group (r = 0.617, P = 0.014) (r = -0.542, P = 0.025). Conclusion: The combined detection of NT-proBNP and MMP-9 is of great significance in determining early ventricular remodeling of high-risk non-ST segment elevation acute coronary syndromes.