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目的:观察CD40L和基质金属蛋白酶(MMPs)与冠脉支架介入治疗术后冠状动脉再狭窄的关系,并分析CD40L和MMPs检测的临床意义。方法:选择330例行冠脉支架置入术冠心病患者。对所有患者分别于术前,术后1个月,6个月,1年,采用ELISA法测定CD40L、C反应蛋白(CRP)、MMP-2、MMP-9。按照冠状动脉狭窄评分(CSA),再将32例支架术后再狭窄患者分为Ⅰ、Ⅱ、Ⅲ3组。结果:冠状动脉狭窄患者术后1个月,6个月,1年CD40L、CRP,MMP-2、MMP-9等较术前均有显著降低,术后再狭窄患者上述指标增高明显,随病情加重而升高,CSA积分越高上述指标增高越明显。MMP-2、MMP-9与CD40L呈正相关性(分别为r=0.51,r=0.64)。结论:CD40L和MMPs与支架术后冠状动脉再狭窄形成有一定的相关性,CD40L和MMPs的检测,有助于冠脉支架术后临床疗效的评价。
Objective: To observe the relationship between CD40L, matrix metalloproteinases (MMPs) and coronary artery stenosis after coronary stent implantation, and to analyze the clinical significance of CD40L and MMPs detection. Methods: 330 patients undergoing coronary stenting were enrolled in this study. The levels of CD40L, C-reactive protein (CRP), MMP-2 and MMP-9 were measured by ELISA in all patients before operation, 1 month, 6 months and 1 year after operation. According to the Coronary stenosis score (CSA), 32 patients with postoperative restenosis were divided into Ⅰ, Ⅱ and Ⅲ groups. Results: The levels of CD40L, CRP, MMP-2 and MMP-9 in patients with coronary artery stenosis at 1 month, 6 months and 1 year after operation were significantly lower than those before operation, and the above indexes increased significantly after restenosis. Increased and increased, the higher the CSA points the above indicators increased significantly. There was a positive correlation between MMP-2, MMP-9 and CD40L (r = 0.51, r = 0.64, respectively). Conclusion: There is a correlation between the expression of CD40L and MMPs and coronary artery restenosis after stent implantation. The detection of CD40L and MMPs is helpful to evaluate the clinical effect of coronary stent.