Study Of Correlation About Coronary Artery Actasia With High Sensitivity C-reactive Protein And Matrix Metalloproteinase-9

ObjectiveBy deceting the concentration of high sensitivity C-reactive protein(hs-CRP) andmatrix metalloproteinase(MMP-9) in coronary artery actasia (CAE) patients,exploring the correlation between CAE and the levels of hs-CRP andMMP-9,exploring the possible mechanism inflammation in the pathogenesis of CAE,in order to take specific measures to improve the efficacy of treatment.Clinical data and methodsClinical dataDuring September2012to February2014at the Second Affiliated Hospital ofZhengzhou University,511patients who have chest pain and chest tightness and othersymptoms as the main clinical manifestation or who have the presence of ECG,treadmill exercise test and noninvasive examination showed objective evidence ofmyocardial ischemia and coronary angiography in parallel (Coronary angiography,CAG).Exclusion criteria:①the diseases that cause chest pain, chest tightness, such aspulmonary embolism, aortic dissection, hypertrophic cardiomyopathy;②inflammatory diseases, such as:acute and chronic infection, pericarditis;③patientswith recent trauma or major surgery, etc;④cancer, autoimmune diseases;⑤severecardiopulmonary dysfunction, liver and kidney dysfunction. Continuous screening ofisolated coronary artery ectasia (isolated coronary artery ectasia, ICAE) in18patients (i.e. isolated coronary artery ectasia), including14cases of male patients,4femalepatients; While filtering out22cases of obstructive coronary artery disease (OCAD)patients, including17cases of male patients,5female patients. And20CAE withOCAD patients were screened, including15male patients and5female patients. Andat the same time, screening of patients with normal CAG (patients with normalcoronary artery, NCA)20cases,16males and4females.MethodsMethods to filtering the enrolled patientsAll the patients were enrolled in the cath lab line CAG surgery, using theseldinger’s law to puncturing right side of the radial artery or the right femoral artery,conducting the catheter to the left and right coronary opening inturn,multi-directional projection were set(left coronary angiography using liver bits,plus left anterior oblique head position, right shoulder position, the spider bit; rightcoronary angiography using the left anterior oblique and right anterior oblique, etc),and by two or more experienced interventional cardiologists read the piece using thevisual method and reached the diagnostic under the premise that the patientsinformation unknowingly. ICAE group: localized or diffuse coronary dilatation,diameter expansion than the adjacent normal or exceed the upper limit of normaldiameter1.5-2times, and exclusion associated with coronary artery stenosis and otherdiseases caused by CAE, including coronary artery stenosis, congenital coronaryartery anomalies, systemic vascular inflammatory disease, connective tissue disease,hereditary collagen disease, coronary intervention and so on. OCAD group: By CAGcheck to make sure that at least one branch of coronary artery stenosis in excess of50%, and the exclusion of the patients with coronary artery occlusive disease.CAE+OCAD group: Patients who have both inclusion criteria as previously. NCAgroup: by CAG check to make sure, normal coronary arteries, vascular lesions notfound.Specimen collection and testing methodsTo exclude the influence of coronary angiography or contrast agent (Iohexol) onpatients, the eligible patients were admitted to hospital the next morning or beforecoronary angiography (8hours of fasting antecubital reagent) before the elbow fasting blood collected into heparin reagent2ml tubes stand for2hours, abandonhemolysis, use a centrifuge at3000rpm per minute speed centrifugation for10minutes, draw the upper liquid200μL serum stored in EDTA tubes and cold storagebackup. By enzyme-linked immune sorbent assay(ELISA), and in strict accordancewith the kit instructions to texting MMP-9concentration. Plasma hs-CRP levels bythe hospital laboratory using ultra-sensitive immune turbidimetry completedtransmission.Statistical methodsAll data were processed by the statistical software SPSS19.0, the measurementdata are mean±standard deviation (’x±s) that the T-test for comparison betweengroups, count data among the groups were compared by using chi-square test(χ2) thatP<0.05represents a statistically significant difference; using Pearson ’s correlationbetween the two variables test, P＜0.05mean that there was statistically significant.ResultsComparison of selected patients with General information511cases of patients examined in CAG in our hospital from September2012toFebruary2014, which continuous random screening ICAE18patients,22cases ofpatients with OCAD, CAE merger OCAD20patients and20patients with NCA.Comparison of selected patients with general information (age, sex, risk factors, etc.)showed no significant difference (P＞0.05).hs-CRP, MMP-9results compareCAE group hs-CRP concentrations(8.29±2.55)mg/L and MMP-9levels(301.5±68.8)pg/ml were significantly higher than the OCADgroup(hs-CRP:5.14±1.24mg/L; MMP-9:207.9±70.5pg/ml) and NCA group(hs-CRP:1.57±0.75mg/L;MMP-9:154.7±50.7pg/ml), which is statistically significant (P <0.05).The CAE group was divided into two subgroups (ICAE group and CAE+OCADgroup) for statistical comparison: hs-CRP concentrations and MMP-9concentrationin ICAE group(hs-CRP:9.35±2.71mg/L; MMP-9:332.5±65.9pg/ml) were higher thanCAE+OCAD group(hs-CRP:7.34±2.01mg/L; MMP-9:273.6±60.1pg/ml), which isstatistically significant (P <0.05). CAE+OCAD group hs-CRP concentrations andMMP-9levels were higher than the OCAD group and NCA group, which is statistically significant (P <0.05).Analysis of correlation between hs-CRP and MMP-9The concentration of hs-CRP in plasma of patients with CAE was positivelycorrelated with MMP-9(r=0.581, P <0.05).Conclusion1. The inflammatory factor of Hs-CRP was positively associated with MMP-9in plasma of patients with CAE, suggesting that the interaction betweeninflammatory cytokines hs-CRP and MMP-9, and the intrinsic relationbetween the inflammatory reaction and degradation of extracellular matrix.2. The concentration of hs-CRP and MMP-9in plasma of patients with CAEwere increased, suggesting that inflammatory factors as hs-CRP and MMP-9to participate in the formation and development of CAE...