Objective: To investigate changes of levels of soluble CD40 ligand (sCD40L), serum matrix metalloprotein-ase—9 (MMP—9) and serum tissue inhibitor of metalloproteinases — 1 (TIMP— 1) in patients with acute coronary syndrome (ACS) and their correlation. Methods: Enzyme—linked immunosorbent assay was used to measure levels of sCD40L, MMP—9 and TIMP—1 in 70 patients with coronary heart disease (CHD) [35 ACS cases, 35 cases with stable angina pectoris (SAP)] and 35 non— CHD patients (normal control group). Results: Compared with normal control group and SAP group, the levels of sCD40L [ (2. 73±0. 92) μg/ml vs. (3. 05±0. 98) μg/ml vs. (4. 72±1. 15) pig/ml] and MMP-9 [ (152. 38±54. 22) ng/ml vs. (341. 12±69. 96) ng/ml vs. (574. 2±139. 20) ng/ml] significantly increased, and level of TIMP-1 [ (415. 92±13. 96) ng/ml vs. (249. 32±36. 80) ng/ml vs. (172. 20±40. 10) ng/ml] significantly decreased in ACS group, P＜0. 01 all; MMP—9 level was positively correlated with sCD40L level (r=0. 42, P＜0. 05). Conclusion: Increased levels of sCD40L and serum MMP—9 and decreased serum TIMP—1 level in ACS patients may be related with instability of atheromatous plaque, and they could serve as serological indicators for instability of atheromatous plaque.%目的:观察急性冠脉综合征(ACS)患者可溶性CD40配体(sCD40L)及血清基质金属蛋白酶-9(MMP-9)、血清组织金属蛋白酶抑制物-1(TIMP-1)水平变化及其相关性.方法:采用酶联免疫吸附法测定70例冠心病患者[ACS患者35例、稳定型心绞痛(SAP)患者35例]、35例非冠心病患者(正常对照组)sCD40L、MMP-9,TIMP-1的水平.结果:与正常对照组及SAP组比较,ACS组sCD40L[(2.73±0.92)μg/ml比(3.05±0.98)μg/ml比(4.72±1.15)μg/ml]、MMP-9[(152.38±54.22)ng/ml比(341.12±69.96)ng/ml比(574.2±139.20)ng/ml]水平明显升高(P均<0.01),而TIMP-1[(415.92±13.96)ng/ml比(249.32±36.80)ng/ml比(172.20±40.10)ng/ml]水平明显降低(P<0.01);且MMP-9与sCD40L呈正相关(r=0.42,P<0.05).结论:急性冠脉综合征患者可溶性CD40配体、血清基质金属蛋白酶-9水平升高,血清组织金属蛋白酶抑制物-1水平下降提示这两指标与粥样斑块不稳定相关,可作为判断粥样斑块不稳定的血清学指标.
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