目的 通过探讨急性冠脉综合征(acute coronary syndrome,ACS)患者血浆C-反应蛋白(CRP)、基质金属蛋白酶-9(MMP-9)水平的变化,揭示血管炎性反应在ACS发病机制中的作用。方法 选择60例ACS患者作为病变组,其中ST段抬高心肌梗死(ST elevated myocardial infarction,STEMI)20例,非ST段抬高心肌梗死(NSTEMI)13例,不稳定型心绞痛(unstable angina pectoris,UAP)27例;对照组为慢性稳定型心绞痛(stable angina pectoris,SAP)组40例,应用ELISA(酶联免疫吸附双抗夹心法)法检测两组患者的血清CRP、MMP-9水平,进行相关统计学处理。结果 ACS组血浆CRP水平测定结果高于对照组,差异具有统计学意义(P<0.01),AMI组血浆CRP水平测定结果高于UAP组,差异具有统计学意义(P<0.01),且血浆CRP水平高低与ACS的严重程度呈正相关。ACS组血浆MMP-9测定结果高于对照组(P<0.01),AMI组MMP-9水平测定结果高于UAP组,差异具有统计学意义(P<0.01),且MMP-9水平高低与ACS的严重程度呈正相关。结论 血管炎性反应在ACS发病机制中起非常重要的作用,且与疾病的严重程度明显相关;可为ACS的临床干预及病情预后判断提供参考依据。

Objective To study the role of vascular Inflammatory reaction in pathogenetic mechanison of acute coronary syndrome (ACS) by detection of the levels of plasma C-reactive protein (CRP) and matrix metalloproteinase-9(MMP-9). Methods CRP and MMP-9 concentrations were measured in 60 patients with acute coronary syndrome (ACS)60,13 patients with non ST elevated myo cardiac infarction (NSTEMI), 20 patients with ST elevated myocardiac infarction (STEMI), 27 patients with unstable angina pectoris, and 40 patients with stable angina pectorts. Compared with normal subjects, the levels of CRP and MMP-9 in ACS patrents were all increased significantly (P<0.01). The levels of CRP and MMP-9 in acute myocardiac infarction were significantly higher than in UAP patients (P<0.01), and they had positive relationship with the severity level of ACS. Results Compared with normal subjects,the levels of CRP and MMP-9 in ACS patients increase significantly,showing that they are the signs of dignosis and estimating severity levels in ACS. At the same time, they provide references to treatment and evalution of ACS.