马剑英,张邢炜,孙爱军,钱菊英,王克强,邹云增,葛均波

• 1:复旦大学附属中山医院心内科上海市心血管病研究所
• 2:浙江省杭州市第二人民医院心内科杭州市心血管病研究所

摘要(Abstract)：

目的探讨血清中cathepsin S、基质金属蛋白酶(MMP)-2、MMP-9及高敏C反应蛋白(hs-CRP)水平在冠状动脉不同类型斑块中的价值。方法84例患者入选,其中急性心肌梗死19例,不稳定型心绞痛27例,稳定型心绞痛38例。介入手术之前对"罪犯"血管进行血管内超声(IVUS)检查,然后根据斑块的类型将患者分为稳定斑块、不稳定斑块及破裂斑块组,同时测定血清中上述指标的变化。结果84例患者中,血管内超声发现有36处稳定斑块,18处不稳定斑块,30处破裂斑块。三组患者在参考面积,参考血管管腔面积、病变面积以及重构指数之间差异没有统计学意义。血清测定结果显示,不稳定斑块组血清中cathepsin S浓度较稳定斑块组明显升高(不稳定斑块组0.408±0.136 IU/L,稳定斑块组0.355±0.056 IU/L,P<0.05),余各组之间相比差异无统计学意义;测定MMP-2及MMP-9在三组之间没有明显变化;不稳定斑块组hs-CRP较稳定斑块组明显升高(5.23±4.28 pg/mL比2.30±2.71 pg/mL,P<0.01),不稳定斑块组较破裂斑块组hs-CRP也有明显升高(5.23±4.28 pg/mL比3.19±2.33 pg/mL,P<0.05),但破裂斑块组与稳定斑块组相比差异无统计学意义。结论cathepsin S和hs-CRP升高对于斑块的不稳定具有预测价值,对于患者的预后没有预测价值。

关键词(KeyWords)： 冠状动脉疾病;C反应蛋白质;预后;cathepsin S

Abstract:

Keywords:

基金项目(Foundation): 国家973项目(2006CB503803);; 国家863项目(2006AA02A406)资助

作者(Author): 马剑英,张邢炜,孙爱军,钱菊英,王克强,邹云增,葛均波

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