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目的探讨冠心病患者血清Ⅰ型胶原羧基末端肽(ⅠCTP)的水平变化及临床意义。方法选择64例冠心病患者作为研究对象,根据不同病情分为心肌梗死组(AMI组,n=17)、不稳定性心绞痛组(UAP组,n=21)和稳定性心绞痛组(SAP组,n=26),选择30例健康体检者作为对照组(C组),比较各组受试者之间的血清ⅠCTP、基质金属蛋白酶-2(MMP-2)、MMP-9、C反应蛋白(CRP)及白介素-6(IL-6)水平,并分析ⅠCTP与MMP-2、MMP-9及血管内超声仪检测结果相关性。结果 AMI组、UAP组血清ⅠCTP、MMP-2、MMP-9、IL-6及CRP水平均显著高于SAP组和C组(P<0.05),AMI组血清IL-6水平显著高于UAP组(P<0.05);SAP组最狭窄斑块面积、斑块负荷及脂质、坏死比例均低于UAP组+AMI组(P<0.05),斑块纤维组成高于UAP组+AMI组(P<0.05);ⅠCTP与斑块纤维组成、脂质比例及MMP-2、MMP-9存在正相关(P<0.05)。结论冠心病患者血清ⅠCTP水平明显升高,可作为粥样斑块不稳定性的评估指标。
Objective To investigate the changes and clinical significance of serum type Ⅰ collagen carboxyterminal peptide (Ⅰ CTP) in patients with coronary heart disease. Methods Sixty-four patients with coronary heart disease (CHD) were enrolled in this study. They were divided into MI group (AMI group, n = 17), unstable angina group (UAP group, n = 21) and stable angina group n = 26) .30 healthy subjects were selected as the control group (group C). The serum levels of CTP, MMP-2, MMP-9 and C-reactive protein CRP and interleukin-6 (IL-6), and to analyze the correlation between ITP, MMP-2, MMP-9 and intravascular ultrasound. Results Serum levels of CTP, MMP-2, MMP-9, IL-6 and CRP in AMI group and UAP group were significantly higher than those in SAP group and C group (P <0.05), while serum IL-6 level in AMI group was significantly higher than that in UAP group (P <0.05). The area of the most narrow plaque, plaque burden, lipid and necrosis in SAP group were lower than those in UAP group and AMI group (P <0.05) <0.05). There was a positive correlation between Ⅰ CTP and plaque fiber, lipid ratio, MMP-2 and MMP-9 (P <0.05). Conclusion The serum level of CTC in patients with coronary heart disease is significantly elevated, which can be used as an index to evaluate the instability of atherosclerotic plaques.