目的：探讨 MMP 2和 MMP 9在急性冠状动脉综合征（ACS）患者中的变化及意义。方法通过对141例ACS（其中急性心肌梗死98例，不稳定性心绞痛43例）患者，与40例稳定性心绞痛（SAP）和40例冠状动脉正常（NCA）患者作对照，测定血清中 MMP 2、MMP 9的浓度，同时对急诊 PCI 术者在术后1周再次测血浆中 MMP 2和 MMP 9的表达。结果与 NCA 组及 SAP 组比较，ACS 组中 MMP 2、MMP 9显著升高，差异有统计学意义（P ＜0.01），且术后1周病情稳定后明显降低，与术前比较差异有统计学意义（P＜0.01）。与冠状动脉单支病变相比，双支及三支病变的患者血清中 MMP 2、MMP 9显著升高，差异有统计学意义（P＜0.01）。结论 MMP 2、MMP 9可作为反映 ACS 患者动脉粥样硬化斑块不稳定或破裂的血清学指标，并有助于冠状动脉病变严重程度的危险分层。%Objective To explore the changes and significance of MMP 2 and MMP 9 in acute coronary syndrome (ACS) patients. Methods A total of 141 patients with ACS were treated (98 of which were acute myocardial infarction patients (AMI) and 43 unstable angina pectoris patients (UAP)) ,and compared with 40 patients with stable angina pectoris (SAP) and 40 individuals with normal coronary artery (NCA). We measured the concentration of MMP 2 and MMP 9 in those patients and determined the patients’ plasma expression of MMP 2 and MMP 9 again one week after emergency PCI. Results In comparison with the NCA and SAP groups ,the levels of MMP 2 and MMP 9 were significantly higher in the ACS group (P< 0.01). However ,the levels of MMP 2 and MMP 9 sig-nificantly decreased after one week of operation when ACS patients were in a stable condition ( P < 0.01). Both double and three coronary artery lesions patients showed significantly higher MMP 9 and MMP 2 levels than the single coronary artery lesions ( P <0.01). Conclusions MMP 2 and MMP 9 may serve as serological indicators for ACS patients with instability or rupture of atheroscle-rotic plaque ,and it contributes to risk stratification of severity of coronary artery lesions.
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