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目的探讨金属蛋白酶(MMP-9)血浆水平、基因多态性与血小板膜糖蛋白Ⅵ(GPⅥ)基因多态性在急性冠状动脉综合征(ACS)发病中的作用及其相关性。方法对179例经冠状动脉造影及临床表现证实为ACS的患者与164例经冠状动脉造影证实无冠状动脉病变的对照者进行研究,采用ELISA法测定血浆MMP-9水平;Clauss法测定纤维蛋白原(Fib)水平;采用多聚酶链反应-限制性内切酶片断长度多态性(PCR-RFLP)分析MMP-9基因中C-1562T、G5564A和GPⅥT13254C、FibBβ链-148C/T基因多态性。结果ACS组血浆MMP-9和Fib水平明显高于对照组,P<0·001;急性心肌梗死组的血浆Fib水平高于不稳定性心绞痛组,P<0·05。ACS组与对照组比较,MMP-9/C-1562T、MMP-9/G5564A和GPⅥT13254C、FibBβ链-148C/T基因型与等位基因频率分布差异无统计学意义。当FibBβ链出现T等位基因时,血浆Fib水平明显升高,P<0·05。显示MMP-9及Fib与ACS发病呈明显正相关(r=0·289,P<0·01)。结论MMP-9及Fib是ACS发病的独立危险因素,FibBβ链T等位基因与血浆Fib水平升高有关,MMP-9C-1562T、G5564A和GPⅥT13254C、FibBβ链-148C/T等位基因频率分布在ACS组对照组之间差异无统计学意义。
Objective To investigate the role and association of plasma MMP-9 level, polymorphism and GPVI polymorphism in the pathogenesis of acute coronary syndrome (ACS). Methods A total of 179 patients with ACS confirmed by coronary angiography and clinical manifestations and 164 patients with coronary artery lesions confirmed by coronary angiography were studied. The plasma MMP-9 levels were measured by ELISA. The levels of fibrinogen (Fib). The polymorphisms of C-1562T, G5564A and GPⅥT13254C and FibBβ chain-148C / T in MMP-9 gene were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results The levels of plasma MMP-9 and Fib in ACS group were significantly higher than those in control group (P <0.001). The plasma levels of Fib in acute myocardial infarction group were significantly higher than those in unstable angina group (P <0.05). ACS group and control group, MMP-9 / C-1562T, MMP-9 / G5564A and GPⅥT13254C, FibBβ chain -148C / T genotype and allele frequency distribution was not statistically different. When T allele was found in FibBβ chain, plasma Fib level increased significantly (P <0.05). There was a positive correlation between MMP-9, Fib and ACS (r = 0.289, P <0.01). Conclusions MMP-9 and Fib are independent risk factors for ACS. FibBβ chain T allele is associated with increased plasma Fib levels. The frequency distributions of MMP-9C-1562T, G5564A and GPⅥT13254C and FibBβ chain-148C / T alleles are There was no significant difference between ACS group and control group.