冠心病患者血清 CysC、Lp-PLA2、MMP-9、PAI-1水平变化及临床意义

摘要

目的：探讨不同类型冠心病患者血清胱抑素 C （CysC）、脂蛋白相关磷脂酶 A2（（Lp-PLA2）、基质金属蛋白酶-9（MMP-9）、纤溶酶原激活物抑制剂-1（PAI-1）水平的变化及其相关性。方法选择经冠状动脉造影术确诊的冠心病住院患者150例，其中稳定型心绞痛（SAP）组28例，无症状心肌缺血组（SMI）59例，急性冠脉综合征（ACS）组63例。采用酶联免疫吸附试验测定血清 CysC、Lp-PLA2、MMP-9、PAI-1水平，采用 Pearson 直线相关分析以上血清学指标的相关性。结果 ACS 组血清 CysC、Lp-PLA2、MMP-9、PAI-1水平明显高于 SMI 组和 SAP 组（P 均＜0．01）。SAP 组血清 CysC、Lp-PLA2、MMP-9、PAI-1水平较 SMI 组升高（P 均＜0．05）。相关分析显示血清 CysC 水平与 Lp-PLA2、PAI-1、MMP-9水平均呈正相关（r 分别为0．790、0．650、0．660，P 均＜0．01）。血清 Lp-PLA2与MMP-9、PAI-1水平呈正相关（r 分别为0．610、0．620，P 均＜0．01）。结论血清 CysC 水平与常见血清学指标具有较好的相关性，联合检测可能有助于冠心病患者危险分层。%Objective To investigate the changes in levels of serum cystatin C,lipoprotein-associated phospholipase A2 (Lp-PLA2),matrix metalloproteinase 9 (MMP-9)and plasminogen activator inhibitor-1 (PAI-1)in patients with dif-ferent extent of coronary heart disease and to study the relationships between them.Methods Totally 150 cases of hospi-talized patients with coronary heart disease confirmed by coronary angiography were selected,including 28 patients with sta-ble angina pectoris (SAP group),59 patients with silent myocardial ischemia (SMI group),and 63 patients with acute coronary syndrome (ACS group).Enzyme-linked immunosorbent assay (ELISA)was used to test the levels of cystatin C, Lp-PLA2,MMP-9 and PAI-1,and Pearson Linear correlation was used to analyze the relationships between the above inde-xes.Results The levels of cystatin C,Lp-PLA2,MMP-9 and PAI-1 in the ACS group were significantly higher than those in the SMI and SAP groups (all P <0.01).And the levels of cystatin C,Lp-PLA2,MMP-9 and PAI-1 in the SAP group were higher than those in the SMI group (all P <0.05).Meanwhile,serum cystatin C level was positively correlated with Lp-PLA2,PAI-1 and MMP-9 (r =0.790,0.650 and 0.660,all P <0.01).The level of blood Lp-PLA2 was positively correlated with MMP-9 and PAI-1(r =0.610,0.620,all P <0.01).Conclusion The level of serum cystatin C is prefer-ably correlated with several common serological indicators,and the combined detection helps to assess the stratification of coronary heart disease risk.