摘要
目的观察原发性高血压患者心肌声学密度(AD)和血清基质金属蛋白酶9(MMP-9)及基质金属蛋白酶组织抑制因子1(TIMP-1)含量的变化,评估其对高血压心肌纤维化的诊断价值,并探讨二者之间的关系。方法选择原发性高血压患者72例,根据左心室质量指数分成心肌肥厚组(40例)和心肌非肥厚组(32例)。健康查体者30例作为正常对照组。采用AD技术测量室间隔矫正的声学强度(CAI1)及背向散射积分周期变化值(CVIB1)、左室后壁矫正的声学强度(CAI2)及背向散射积分周期变化值(CVIB2),酶联免疫法检测血清MMP-9及TIMP-1浓度。结果高血压心肌肥厚组的CAI1和CAI2值均高于心肌非肥厚组及对照组(P<0.01),其CVIB1和CVIB2值均低于心肌非肥厚组及对照组(P<0.01),其血清MMP-9及TIMP-1浓度均高于心肌非肥厚组及对照组(P<0.01),但其二者比值较其他两组降低(P<0.05);心肌肥厚组的血清MMP-9与心肌CAI1和CAI2值呈正相关(P<0.01),与CVIB1和CVIB2值呈负相关(P<0.01),TIMP-1与心肌CAI1和CAI2值呈正相关(P<0.01)。结论高血压患者心肌声学密度定量指标与血清MMP-9和TIMP-1浓度存在相关性,二者均可用于评估高血压心肌纤维化的严重程度。
Objective To evaluate the clinical value of quantitative myocardial acoustic deusitometry in myocardial fibrosis in rel- ative to an alteration in serum metalloproteinase-9 （MMP-9） and tissue inhibitor of metalloproteinase-1 （TIMP-1 ） concentrations in essential hypertensive patients. Methods 72 essential hypertensive patients were divided into two groups based on the left ventrieular mass index： 40 patients with left ventricular hypertrophy（the LVH group） and 32 patients without left ventrieular hypertrophy（the NLVH group）, and 30 normal persons served as healthy controls. Calibrated acoustic intensity in the septal（CA/1 ） and posterior wall（CAI2 ） and cyclic variation of integrated backscatter in the septal（CVIB1 ）and posterior wall（ CVIB2 ） were determined by the AD technique. Concentrations of MMP-9 and TIMP-1 were determined by enzyme-linked immunosorbent assays （ELISA）. Results CAI1 and CAI2 in the LVH group（46.12 ±4.52 and 45.84 ± 5.71, respectively） were significantly higher than those in the NLVH group （ 41.61 ± 5.98 and 41.42 ±5.62, respectively ） and the control group （38.30 ± 3.87 and 37.18 ±3.88, respectively）（P 〈 0.01）. However, CVIB1 and CVIB2 in the LVH group（7.19±1.27 and 8.99± 1.35, respectively） were significantly lower than those in the NLVH group （8.59±1.89 and 10.23± 1.80, respectively） and the control group （9.29 ± 2.11 and 10.92 ± 2.10, respectively）（P 〈 0.01）. MMP-9 and TIMP-1 concentrations in the LVH group （32.75± 4.95 and 83.21 ± 32.65, respectively） were significantly higher than those in the NLVH group（28.20± 5.70 and 60.09 ±28.51,respectively ） and the control group （25.26 ± 5.97 and 38.18 ± 10.61, respectively ）（ P 〈 0.01 ）, while the MMP-9/TIMP-1 ratio in the LVH group （0.46±0.24） was significantly lower than that in the NLVH group （0.57±0.21） and the control group （0.69 ±0.19） （ P 〈 0.05）. MMP-9 level in the LVH group was positively related to CAI1 an
出处
《山东大学学报（医学版）》
CAS
北大核心
2008年第11期1045-1048,共4页
Journal of Shandong University:Health Sciences
关键词
心肌声学密度
高血压
明胶酶B
Myocardial acoustic densitometry
Hypertension
Gelatinase B
