基质金属蛋白酶-9对冠心病患者介入治疗后心血管不良事件发生的预测价值

摘要

目的：评估基质金属蛋白酶-9（MMP-9）对冠心病患者介入治疗后心血管不良事件发生的预测价值。方法分析2012年1月—2014年1月接受冠状动脉支架植入术的冠心病患者的临床资料。依据患者术后6个月是否发生心血管不良事件分为2组，发生不良事件为事件组41例，未发生不良事件为非事件组61例。比较2组CRP、MMP-9、IL-6、IL-10、TNF-α的水平及MMP-9对不良事件发生的预测价值。结果事件组患者血清IL-6、IL-10、TNF-α与非事件组差异无统计学意义（ P ＞0 k．05），而CRP、MMP-9水平高于非事件组（ P ＜0．05）。血清CRP水平与MMP-9呈正相关（ r ＝3．126， P ＝0．002）。 ROC曲线分析显示，当MMP-9截值为29．7 pg／ml时预测敏感度为87．80％，特异度为86．89％，CPR截值为16．1 mg／L时分别为68．29％、68．85％，MMP-9优于CRP。结论冠心病患者术后MMP-9升高提示预后不良。%Objective To evaluate the predictive value of matrix metalloproteinase-9 ( MMP-9) in patients with coro-nary heart disease after intervention treatment ’ s cardiovascular adverse events .Methods Analyzed the clinical data of pa-tients with coronary heart disease underwent coronary stent implantation from January 2012 to January 2014 .According to ad-verse cardiovascular events occurred at 6 months after the operation , they were divided into 2 groups, 41 cases in the adverse events group, and 61 cases in the non-event group.The predictive value of MMP-9, and the differences of CRP, MMP-9, IL-6, IL-10, TNF alpha level among the 2 groups were compared.Results In the event group, the level of serum IL-2, IL-6, IL-10, and TNF showed no statistical significance differences from non-event group ( P >0.05), CRP and MMP-9 levels were higher than non-event group ( P <0.05).Correlation of serum CRP level and MMP-9 were positive ( r =3.126, P =0.002).ROC curve analysis showed that when the MMP-9 value was 29.7 pg /ml, predictive sensitivity was 87.80% and specificity was 86.89%, and when CPR values was 16.1 mg /L, these indices were 68.29%, 68.85%and MMP-9 was bet-ter than CRP.Conclusion Patients with coronary heart disease after PCI with MMP-9 increased means poor prognosis .