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目的评价药物与择期经皮冠状动脉介入治疗(PCI)对急性心肌梗死(AMI)后基质金属蛋白酶-1(MMP-1)及其抑制物-1(TIMP-1)的影响。方法对2005年3月至2007年11月贵州省人民医院心内科的41例AMI患者在分别予强化内科药物(药物组,22例)和在此基础上行择期PCI介入(PCI组,19例)治疗。应用酶联免疫法检测AMI患者发病1周、3个月、6个月及12个月时的血清MMP-1和TIMP-1质量浓度。结果与对照组比较,药物组与PCI组各组MMP-1均显著降低;除12个月外,各时点组TIMP-1均显著降低(P<0.05)。两组组内比较,药物组12个月组TIMP-1较3个月及6个月组均显著升高(P<0.05)。两组同期各时点组比较,PCI组3个月及6个月TIMP-1较同期药物组显著升高,同时其6个月组MMP-1/TIMP-1比值较同期药物组显著降低(P<0.05)。结论从抑制原有胶原网络降解的角度而言,择期PCI在AMI后6个月内明显优于药物治疗,而至12个月时择期PCI未进一步显示出此方面的优越性。
Objective To evaluate the effects of drugs and percutaneous coronary intervention (PCI) on the expression of matrix metalloproteinase-1 (MMP-1) and inhibitor of metalloproteinase-1 (TIMP-1) after acute myocardial infarction (AMI) Methods Forty-one AMI patients in the Department of Cardiology of Guizhou Provincial People’s Hospital from March 2005 to November 2007 were enrolled in this study. Forty-two patients received AMI (drug group, n = 22) and PCI (PCI group, 19 patients) treatment. Serum levels of MMP-1 and TIMP-1 at 1 week, 3 months, 6 months and 12 months after onset of AMI were detected by enzyme-linked immunosorbent assay. Results Compared with the control group, the levels of MMP-1 in the drug group and the PCI group were significantly lower than those in the control group. TIMP-1 was significantly decreased at all time points except for 12 months (P <0.05). In the two groups, TIMP-1 in the 12-month group was significantly higher than that in the 3-month and 6-month groups (P <0.05). The TIMP-1 levels in PCI group were significantly higher than those in the same period at 3 months and 6 months in PCI group and the MMP-1 / TIMP-1 ratio in 6 months group was significantly lower than that in the same period P <0.05). Conclusion From the perspective of inhibiting the degradation of the original collagen network, elective PCI was significantly better than drug treatment within 6 months after AMI, and elective PCI did not further demonstrate this superiority by 12 months.