| Introduction No matter in developed countries or developing countries,coronary heart disease(CHD) is one of the most common diseases leading to deformity or even to death. Incidence of CHD declines slightly than before in some areas of Western Europe, America and Australia, but in Middle Europe, Eastern Europe and Northern Europe, including Asia and Africa in some degree, it is still increasing rapidly. Therefore it becomes urgent to prevent from CHD Effectively over the world. In the meantime, the clinic studies in CHD get quicker development, especially the rising of "medicine based of evidence" poures tremendous vitality into the clinic study and basic study in CHD. Acute coronary syndrome(ACS) is the emergent syndrome in CHD,which covers a range of clinical pathophysiological condition,from unstable angina pectoris (UAP), acute myocardial infarction(AMI) without STsegment's elevation to the AMI with ST segment's elevation and so on.its pathogenesis and prevention strategy are two research hot spots in the recent years. Along with the deep-going of the research, as is known, on the basis of coronary artery atherosclerosis, plaque disruption and thrombosis is the main pathophysiological base in the CHD's emergency, especially in the ACS.Angiography shows that most of the plaques ,causeing ACS just like UAP,AMI, sudden death , only cause the stenosis below 70 percents. Unstable plaqueand and the thrombosis formed after it's disruption are the main reasons, many factors can cause the plaque's unstability, Such as the size of lipid core, the thickness of fibrous cap and the content of collagen and so on . to some extent, factors which influence the plaque's stability must also influence the clinic symptoms and prognosisof CHD .Matrix metalloproteinases(MMPs) is a proteinase which can degradate extracellular matrix.it plays an important role on a range of physiological and pathological changes, such as embryo 's forming, tissue's remodeling , malignant tumor's transfering and rheumatic arthritis, and has high research value in various clinic sciences. Since 1962, when Gross and Lapiere discovered the first MMPs-collagenase, man had discovered various of MMPs in succession, where MMP-2 has a strong degradational effect on extracellular matrix, it is secreted bymacrophage, smooth muscle cells and endothelial cells and so on. MMP-2 will degrade the fibrous cap and collagen in the basilar membrane when it is increased in the plaque, and it is one of the important factor to make the fibrous cap thin and accelerate atherosclerosis's development. In my article,MMP-2 level in the serum is detected on the patients with CHD,especially the ACS. and I will study and discuss the relevance between MMP-2 and acute coronary events(ACE), thus reveal its possible clinic significance. purpose Checking the serum MMP-2 level in CHD patients including acute coronary syndrome(ACS) and SAP patients, discussing the relevance between MMP-2 and acute coronary syndrome, and revealing MMP-2 may be the strong index to forecast the occurrence of acute coronary event for CHD patients.Material and methodResearch object All the objects come from our hospital to accept coronary angiography from October 2002 to February 2003, in which 61 patients are diagnosised as CHD, including 46 ACS patients and 15 SAP patients,besides,I establish the control group (namely normal group) with 24 patients. In the ACS group,there are 16 AMI patients and 30 UAP patients.Research methodsCollection and pretreatment of samples 10 ml blood of the every subject will be drawn from artery sheath after the 6F artery sheath is implanted into the right femoral artery but before heparinization when angiography being cerried. Then put the blood into a dry test tube let it coagulate naturally , after centrifugating(1500Xg) for 15 minutes, suck the supernatant namely serum. Storage it in -20℃ for later use. Method Assay the serum MMP-2 with enzyme-linked immunosorbent assay(ELISA),and the test kit is bought from Shanghai Shengxion... |
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