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目的:探讨急性ST段抬高型心肌梗死(STEMI)患者血清白三烯B4(LTB4)和基质金属蛋白酶-9(MMP-9)表达的动态变化及其临床意义。方法:采用酶联免疫吸附法(ELISA)测定40例STEMI患者入院48h及出院后第3个月、6个月血清中LTB4及MMP-9的表达;全自动生化分析仪测定脂蛋白(a)。结果:与入院水平相比,STEMI患者血清LTB4的表达水平在出院后第3个月及第6个月呈持续性下降,结果有统计学意义(P<0.05);出院后第3个月MMP-9的表达显著低于入院时水平(P<0.05),而与第6个月相比差异无统计学意义(P>0.05)。在脂蛋白(a)总体较高25%水平与总体较低25%水平的患者血清中MMP-9的差异有统计学意义(P<0.05)。结论:STEMI患者院外3~6个月随访发现其血清中LTB4和MMP-9的表达呈动态变化,其中LTB4血清水平呈进行性降低,脂蛋白(a)显著增高人群在发生心肌梗死时其MMP-9水平较高。
Objective: To investigate the dynamic changes of serum leukotriene B4 (LTB4) and matrix metalloproteinase-9 (MMP-9) expression in patients with acute ST-segment elevation myocardial infarction (STEMI) and its clinical significance. Methods: The serum levels of LTB4 and MMP-9 in 40 STEMI patients admitted to hospital at 48 h and at 3 and 6 months after discharge were determined by enzyme-linked immunosorbent assay (ELISA). Lipoprotein (a) . Results: Compared with hospital admission, the level of serum LTB4 in STEMI patients decreased continuously at the third month and the sixth month after discharge, with a statistically significant difference (P <0.05). After the third month after discharge, the level of MMP -9 was significantly lower than that at admission (P <0.05), but no significant difference compared with the 6th month (P> 0.05). There was a statistically significant difference (P <0.05) in the serum levels of MMP-9 between patients with a higher 25% overall level of lipoprotein (a) and a generally lower 25% level. CONCLUSIONS: The levels of LTB4 and MMP-9 in STEMI patients after 3 ~ 6 months of follow-up were dynamic. The level of LTB4 in serum was decreased in a progressive manner. Lipoprotein (a) was significantly increased in patients with myocardial infarction -9 level is higher.