血清MMP-8/TIMP-1 水平与ACS 患者 心功能及预后的相关性分析

Relationships of serum MMP-8/TIMP-1 ratio with cardiac function and prognosis of patients with acute coronary syndrome

摘要:

目的 探讨血清基质金属蛋白酶-8（MMP-8）/ 基质金属蛋白酶抑制剂-1（TIMP-1）与急 性冠状动脉综合征（ACS）心功能及其预后的相关性。方法 选取行冠状动脉造影检查者160 例，其中105 例确诊ACS 患者作为ACS 组，其余55 例健康者作为对照组。比较两组血清MMP-8、TIMP-1 及左室射 血分数（LVEF）。ACS 组行常规治疗，PCI 术后7 d 再次检测血清MMP-8、TIMP-1、MMP-8/TIMP-1 及 LVEF，出院后随访≥ 1 年，统计ACS 组支架血栓发生率和生存率。分析ACS 患者血清MMP-8/TIMP-1 与LVEF、支架血栓发生率及1 年生存率的关系及其预后的价值。结果 与对照组比较，ACS 组MMP-8、 TIMP-1 及MMP-8/TIMP-1 水平升高，LVEF 降低（P <0.05）。与术前比较，ACS 组术后7 d MMP-8、 TIMP-1 及MMP-8/TIMP-1 降低，LVEF 升高（P <0.05）。ACS 组随访1 年支架血栓发生率和生存率分别为 8.57% 和85.71%。与存活患者比较，ACS 组死亡患者围手术期MMP-8/TIMP-1 升高，LVEF 降低（P <0.05）。 与无支架血栓患者比较，有支架血栓患者术期血清MMP-8/TIMP-1 水平升高，LVEF 降低（P <0.05）。ACS 患者血清MMP-8/TIMP-1 水平与LVEF 和1 年生存率均呈负相关（P <0.05），与其支架血栓发生率则呈正 相关（P <0.05）。结论 血清MMP-8/TIMP-1 水平与ACS 患者LVEF、支架血栓和生存预后均密切相关， 可作为其病情和预后评估的参考指标。

Abstract:

Objective To investigate the relationships of serum metalloproteinase-8 (MMP-8)/tissue inhibitor of metalloproteinase-1 (TIMP-1) with cardiac function and prognosis of acute coronary syndrome (ACS). Methods A total of 160 cases having coronary angiography were selected. Among them, 105 patients diagnosed as ACS were enrolled in the ACS group, and 55 healthy subjects were enrolled in control the group. Serum MMP-8 and TIMP-1 levels, MMP-8/TIMP-1 and LVEF of the two groups were detected. The patients in the ACS group had PCI treatment, and serum MMP-8 and TIMP-1 levels, MMP-8/TIMP-1 and LVEF were detected again 7 d after PCI. The 1-year survival rate and stent thrombosis rate of the ACS group were counted. The relationships of serum MMP-8/TIMP-1 with LVEF, stent thrombosis rate and 1-year survival rate in the ACS patients were analyzed, and the value of serum MMP-8/TIMP-1 in predicting the 1-year stent thrombosis rate and survival prognosis was analyzed. Results Compared with the control group, serum MMP-8, TIMP-1 levels and MMP-8/TIMP-1 in the ACS group were increased, while LVEF in the ACS group was decreased (P < 0.05). Compared with the preoperative values, serum MMP-8, TIMP-1 levels and MMP-8/TIMP-1 were decreased, while LVEF was increased 7 days after PCI in the ACS group (P < 0.05). The 1-year follow-up stent thrombosis rate and survival rate in the ACS group were 8.57% and 85.71% respectively. Compared with the survivors, serum MMP-8/TIMP-1 ratio was increased, while LVEF was decreased in the dead patients of the ACS group (P < 0.05). Compared with the patients without stent thrombosis, serum MMP-8/TIMP-1 ratio was increased, while LVEF was decreased in the patients with stent thrombosis in the ACS group (P < 0.05). In the ACS patients, serum MMP-8/TIMP-1 ratio was negatively correlated with LVEF and 1-year survival rate (P < 0.05), while positively correlated with the stent thrombosis rate (P < 0.05). Conclusions Serum MMP-8/TIMP-1 ratio in ACS patients is closely related to LVEF, stent thrombosis and 1-year survival rates, which may be used as a reference index for disease severity and prognosis evaluation.