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目的:探讨早期检测急性心肌梗死(AMI)患者血清基质金属蛋白酶3(MMP-3)水平的临床意义。方法:50例AMI患者按发病时间依次分为3个时间段(0～4h、4～6h及6～12h),分别检测MMP-3、肌钙蛋白I(cTnI)和肌酸激酶同工酶(CK-MB)的含量,并与对照组、稳定型心绞痛(SAP)组、不稳定型心绞痛(UAP)组进行比较分析,描绘相应的受试者特征曲线(ROC)并进行分析。结果:AMI患者中,MMP-3水平于发病0～4h内已明显升高,显著高于对照组、SAP组及UAP组(P<0.05),且在4～6h、6～12h时段仍持续升高;而cTnI和CK-MB水平在发病4～6h后才开始升高,并于6～12h内继续增高。cTnI在AMI组(0～4h)的ROC曲线下面积最大,MMP-3次之,CK-MB最小。结论:MMP-3在AMI早期具有较高的敏感度及特异性,对AMI的早期诊断具有较高的临床价值。
Objective: To investigate the clinical significance of detecting the serum level of matrix metalloproteinase 3 (MMP-3) in patients with acute myocardial infarction (AMI) in the early stage. Methods: Fifty patients with AMI were divided into 3 time periods (0 ~ 4h, 4 ~ 6h and 6 ~ 12h) according to the onset time. The levels of MMP-3, cTnI and creatine kinase (CK-MB), and compared with the control group, stable angina pectoris (SAP) group and unstable angina pectoris (UAP) group. The corresponding patient’s characteristic curve (ROC) was plotted and analyzed. Results: The levels of MMP-3 in AMI patients were significantly increased from 0 to 4 hours after onset, which were significantly higher than those in control group, SAP group and UAP group (P <0.05), and continued at 4 to 6 hours and 6 to 12 hours While the levels of cTnI and CK-MB began to increase after 4 ~ 6h, and continued to increase within 6 ~ 12h. The area under the ROC curve of cTnI in AMI group (0 ~ 4h) was the largest, followed by MMP-3, and CK-MB was the smallest. Conclusion: MMP-3 has high sensitivity and specificity in the early stage of AMI and has high clinical value in the early diagnosis of AMI.