目的：探讨MMP-9、TIMP-1检测对评估慢性心衰发生及发展的意义．方法观察组为慢性心衰患者127例，对照组选自社区健康人群40例研究对象，分别检测血MMP-9、TIMP-1并进行超声心动图检查明确LVEF及E/E'．结果观察组患者MMP-9显著高于对照组（＜0.01）， TIMP-1较对照组有显著性下降（＜0.05），MMP-9/TIMP-1较对照组存在显著性升高（＜0.05）．观察组LVEF、E/E'较对照组差异具有显著统计学意义（＜0.05）．观察组心功能III级MMP-9、MMP-9/TIMP-1较心功能II级者出现显著性升高（＜0.05）， TIMP-1较心功能 II级者出现极显著性下降（＜0.05）．LVEF、E/E'较心功能 II级者有显著性升高（＜0.05）．心功能IV级患者MMP-9、TIMP-1、MMP-9/TIMP-1均较心功能II、III级患者显著差异（＜0.05）， LVEF、E/E'较心功能 II 级者有显著性升高（＜0.05），但较 III 级患者并无显著性差异（＞0.05）． MMP-9+TIMP-1+MMP-9/TIMP-1较MMP-9、TIMP-1、MMP-9/TIMP-1单一指标具有更高的灵敏度及特异度，而LVEF+E/E'联合诊断价值较IL-18+NT-ProBNP为差．结论 MMP-9、TIMP-1及其比值测定有助于慢性心衰早期发现与诊断，并有助于判断病情进展．%Objective To investigate the significance of MMP-9 and TIMP-1 test for assessing the occurrence and development of chronic heart failure.Methods One hundred and twenty-seven patients with chronic heart failure were enrolled in the observation group,and 40 cases community health people were selected for the control group. The levels of serum MMP-9 and TIMP-1 were detected and the LVEF and E/E ' were evaluated using endocardiography. Results Compared with the control group, the level of MMP-9 was significantly higher (<0.01) but the level of TIMP-1 had significantly decreased ( <0.05) in the observation group. And the ratio of MMP-9 and TIMP-1 had significantly increased compared with the control group ( <0.05) . There were statistically significant differences of LVEF and E/E' between the observation group and control group ( <0.05) . In the observation group,the level of MMP-9, MMP-9/TIMP-1,LVEF and E/E' were increased but the level of TIMP-1 decreased significantly in cases with cardiac functional class III compared with cardiac function class II (<0.05) . There were significant differences between the cases with class IV heart function and class II, III in the levels of MMP-9, TIMP-1 and MMP-9/TIMP-1 ( <0.05) . In the cases of class IV heart function, the LVEF and E/E' have significantly increased compared with the cases of class II ( <0.05) . MMP-9 + TIMP-1 +MMP-9/TIMP-1 combination has higher sensitivity and specificity than the MMP-9,TIMP-1 and MMP-9/TIMP-1 single indicator, and the joint diagnostic value of LVEF + E/E' was less than that of IL-18+ NT-ProBNP. Conclusion The levels of MMP-9 and TIMP-1 and their ratio may have contributed to the early detection and diagnosis for chronic heart failure,and help to determine the disease progression.
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