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目的:探讨冠脉经皮冠状动脉介入(PCI)治疗后血浆脂蛋白相关磷脂酶A2(LP-PLA2)与基质金属蛋白酶-9(MMP-9)水平的变化及其临床意义。方法:选择150例急性冠脉综合征(ACS)患者、128例稳定型心绞痛(SAP)患者及100例健康者分为作为ACS组、SAP组及对照组。比较三组入院时血浆MMP-9、LP-PLA2水平及ACS组经PCI治疗前后血浆MMP-9、LP-PLA2水平的变化。结果:与对照组比较,SAP组与ACS组的血浆MMP-9、LP-PLA2水平均明显增高(P<0.05);与SAP组比较,ACS组明显增高(P<0.05)。与术前比较,ACS组术后血浆MMP-9、LP-PLA2水平明显降低(P<0.05)。MMP-9与LP-PLA2在ACS组血浆中呈显著正相关(r=0.617,P<0.05),在SAP组与对照组中无相关性(P>0.05)。结论:冠脉病变程度越严重,血浆MMP-9和LP-PLA2水平更高;PCI治疗后冠脉斑块趋于稳定,血浆MMP-9和LP-PLA2水平降低,且二者有相关性,提示MMP-9和LP-PLA2参与冠状动脉粥样硬化的发病与发展,且对预测ACS高危人群及评价疗效有一定的临床价值。
Objective: To investigate the changes of plasma lipoprotein associated phospholipase A2 (LP-PLA2) and matrix metalloproteinase-9 (MMP-9) after percutaneous coronary intervention (PCI) in coronary artery. Methods: A total of 150 patients with acute coronary syndrome (ACS), 128 patients with stable angina pectoris (SAP) and 100 healthy controls were enrolled as ACS group, SAP group and control group. The plasma levels of MMP-9 and LP-PLA2 at admission and plasma levels of MMP-9 and LP-PLA2 in ACS group before and after PCI were compared. Results: Compared with the control group, the levels of plasma MMP-9 and LP-PLA2 in SAP group and ACS group were significantly increased (P <0.05). Compared with SAP group, ACS group was significantly increased (P <0.05). Compared with preoperative, plasma levels of MMP-9 and LP-PLA2 in ACS group decreased significantly (P <0.05). There was a significant positive correlation between MMP-9 and LP-PLA2 in ACS plasma (r = 0.617, P <0.05), but no correlation between MMP-9 and control group (P> 0.05). Conclusion: The severity of coronary artery disease is more serious and the levels of plasma MMP-9 and LP-PLA2 are higher. Coronary plaque tends to be stable and the levels of plasma MMP-9 and LP-PLA2 are lower after PCI, It is suggested that MMP-9 and LP-PLA2 are involved in the pathogenesis and development of coronary atherosclerosis, and have certain clinical value in predicting ACS high-risk population and evaluating the curative effect.