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目的探讨血清基质金属蛋白酶-9(matrix metalloproteinases-9,MMP-9)水平在射血分数下降性心力衰竭和射血分数正常性心力衰竭患者的变化及其与射血分数正常性心力衰竭患者预后的关系。方法顺序选取2009年2-9月天津医科大学总医院心血管病中心因心力衰竭住院患者172例分为两组:射血分数下降性心力衰竭组98例(A组),射血分数正常性心力衰竭组74例(B组),测定两组患者血清MMP-9和NT-ProBNP水平,行多普勒超声心动图检查,随访患者出院后12周因心力衰竭加重导致死亡和再入院人数。结果 B组血清MMP-9水平高于A组[分别为(7.41±4.25)ng/ml,(5.90±3.52)ng/ml,P=0.009];B组MMP-9水平与NT-ProBNP水平呈负相关(R=-0.270,P=0.017),与左室舒末径(LVDD)、左室质量指数(LVMI)、左室射血分数(LVEF)呈正相关(分别为R=0.243,P=0.033;R=0.234,P=0.040;R=0.289,P=0.011);B组患者血清MMP-9水平越高,死亡和再入院的风险越高(P<0.01)。结论射血分数正常性心力衰竭患者血清MMP-9较射血分数下降性心力衰竭患者高,MMP-9水平可以作为评价射血分数正常性心力衰竭患者预后指标之一。
Objective To investigate the changes of serum matrix metalloproteinases-9 (MMP-9) levels in patients with decline of ejection fractional heart failure and ejection fraction normal heart failure and their relationship with prognosis of patients with ejection fraction normal heart failure Relationship. METHODS: From January to September in 2009, 172 inpatients with heart failure admitted to the Cardiovascular Center of Tianjin Medical University General Hospital were divided into two groups: 98 cases (group A) with ejection fractional heart failure, normal ejection fraction 74 cases of heart failure group (group B). The levels of serum MMP-9 and NT-ProBNP were measured in both groups. The number of death and re-admission after 12 weeks of follow-up due to heart failure was followed up. Results The level of serum MMP-9 in group B was significantly higher than that in group A [(7.41 ± 4.25) ng / ml, (5.90 ± 3.52) ng / ml, P = 0.009] Negative correlation (R = -0.270, P = 0.017) was positively correlated with LVDD, LVMI, LVEF (R = 0.243, P = 0.033; R = 0.234, P = 0.040; R = 0.289, P = 0.011). The higher the level of serum MMP-9 in group B, the higher the risk of death and rehospitalization (P <0.01). Conclusion Serum MMP-9 levels in patients with ejection fraction normal heart failure are higher than those in patients with ejection fractional decline in heart failure, and MMP-9 level may be used as a prognostic indicator in patients with normal ejection fraction of heart failure.