中国全科医学Issue(18)：2073-2078,6.DOI:10.3969/j.issn.1007-9572.2014.18.006
基质金属蛋白酶9对ST段抬高型心肌梗死的诊断价值研究
Evaluation of Diagnostic Value of Matrix Metalloproteinase-9 for ST-segment Elevation Myocardial Infarction
摘要
Abstract
Objective To evaluate the diagnostic value of matrix metalloproteinase -9(MMP-9)for ST segment el-evation myocardial infarction(STEMI)by using ROC curve. Methods From September 2011 to February 2012,55 adult Han patients who were first diagnosed with STEMI in coronary care unit( CCU)at the heart center of the First Affiliated Hospital of Xinjiang Medical University,were selected as STEMI( Duration of typical chest pain >30 min,elevation of ST segment in two neighboring leads or more than two leads >0. 1 mV)group. Meanwhile,50 cases in general ward at the heart center with symp-toms of atypical chest pain but abnormality of left and right coronary arteries was not found by coronary angiography,were selected as control group. Plasma levels of MMP-9 and CK-MB were determined at the following different time slots after the myocardial infarction symptom onset respectively:t≤4 h( Group≤4 h),4 h<t≤8 h( Group 4 h<t≤8 h),8 h<t≤12 h( Group 8 h<t≤12 h),12 h<t≤24 h( Group 12 h<t≤24 h),24 h<t≤48 h( Group 24 h<t≤48 h). ROC curve was used to evalu-ate the diagnostic value of MMP-9 and CK-MB for STEMI. Results There were significant differences in gender composition, age,smoking rate,BMI,white cell count,monocyte count and Cr level between STEMI group and control group(P<0. 05);There was no significant difference in levels of TC and TG,lymphocyte count between STEMI group and control group( P >0. 05). At different time slots,there were significant differences in plasma levels of MMP-9 and CK -MB between STEMI group and control group(P<0. 05). In Group≤4 h,Group 4 h<t≤8 h,Group 8 h<t≤12 h,Group 12 h<t≤24 h and Group 24 h<t≤48 h,plasma levels of MMP-9 in STEMI group patients were all significantly higher than those in control group patients(P<0. 05). In Group 4 h<t≤8 h,Group 8 h<t≤12 h,Group 12 h<t≤24 h and Group 24 h<t≤48 h,plasma levels of CK-MB in STEMI patients were all significantly higher than those in control group patients(P<0. 05). In Group≤4 h,area under the curve( AUC)for MMP-9 and CK-MB was 0. 987 and 0. 852 respectively,Youden index was 0. 880 and 0. 642 respectively. In Group 4 h<t≤8 h,AUC for MMP-9 and CK-MB was 0. 949 and 0. 967 respectively,Youden index was 0. 869 and 0. 855 respectively. In Group 8 h<t≤12 h,AUC for MMP-9 and CK-MB was 0. 995 and 0. 976 respectively, Youden index was 0. 962 and 0. 927 respectively. In Group 12 h<t≤24 h,AUC for MMP-9 and CK-MB was 0. 989 and 0. 955 respectively,Youden index was 0. 944 and 0. 873 respectively. In Group 24 h < t≤48 h, AUC for MMP -9 and CK-MB was 0. 977 and 0. 870 respectively,Youden index was 0. 944 and 0. 687 respectively. Conclusion The degree of ele-vation of serum MMP-9 is higher in the early stage of symptom onset among STEMI patients,to some extent,MMP-9 has diag-nostic value for early STEMI and for late STEMI.关键词
冠状动脉疾病/基质金属蛋白酶9/心肌梗死/肌酸激酶,MB型/诊断Key words
Coronary artery disease/Matrix metalloproteinase 9/Myocardial infarction/Creatine kinase, MB form/Diagnosis分类
医药卫生引用本文复制引用
门莉,杨毅宁,马依彤,孙惠萍,李晓梅,刘芬,赵倩,郭俊林,李东泽..基质金属蛋白酶9对ST段抬高型心肌梗死的诊断价值研究[J].中国全科医学,2014,(18):2073-2078,6.基金项目
教育部新世纪优秀人才支撑计划 （）
