| Objective:The pathological mechanism of acute coronary syndrome(ACS)is related to the formation and rupture of vulnerable plaque,and the degradation of extracellular matrix plays an important role.The extracellular matrix metalloproteinase inducer(EMMPRIN)is the upstream molecule of matrix metalloproteinases(MMPs).In our previous study,we confirmed that EMMPRIN was associated with the stability of atherosclerotic vulnerable plaque.EMMPRIN regulation of MMPs in vulnerable plaque is specific to the relationship between EMMPRIN and the MMPs family.This study is to determine the surface of the platelet and the mononuclear cell surface of the patients with acute coronary syndrome.The expression level of EMMPRIN,the expression level of MMP-1,MMP-3 and MMP-9 in the serum and the correlation between EMMPRIN and MMP-1,MMP-2,MMP-3 and MMP-9,and the relationship between them and the clinical significance of the occurrence and development of ACS.At the same time,64 slice spiral CT coronary angiography was used to evaluate the clinical value of EMMPRIN and MMP-1,MMP-2,MMP-3,MMP-9 expression for acute coronary syndrome.Methods:From May 2017 to October 2017,116 cases of Coronary heart disease(CHD)were diagnosed in the Department of Cardiology of the General Hospital of Kunming general hospital,and 38 cases of normal coronary angiography were collected as the control group,and there are 154 cases in the study.Group CHD was divided into 38 cases of acute myocardial infarction(Acute myocardial infarction,AMI),36 cases of unstable angina pectoris group(Unstable angina pectoris,UAP),and 42 cases of stable angina pectoris group(Stable angina pectoris).Group CHD,according to CT coronary artery examination,was divided into 50 groups of soft plaque group,45 cases of fibrous plaque group and 21 cases of calcified plaque group.Group CHD,according to the range of vascular involvement,was divided into 44 cases of single branch group,44 cases of double branches group,and 28 cases of branches group.The expression level of EMMPRIN on the surface of platelets and monocytes was detected by flow cytometry,and the expression level of MMP-1,MMP-2,MMP-3 and MMP-9 in serum was detected by enzyme linked immunosorbent assay(ELISA).Results:1.The expression level of EMMPRIN on platelets and monocytes in different clinical types.The level of EMMPRIN expression on the surface of platelets,AMI group was higher than the UAP group,and the group UAP was higher than SAP group,and the three groups were all higher than the control group.The difference was statistically significant(P<0.05).The level of EMMPRIN expression on the surface of monocyte was not statistically significant(P>0.05),AMI group was higher than the SAP group,UAP group was higher than the SAP group.The three groups were higher than the control group,and the differences were statistically significant(P<0.05).2.The expression levels of MMP-1,MMP-2,MMP-3 and MMP-9 in different clinical types.The difference of serum MMP-1 expression level between groups was statistically significant(P<0.01),the difference between group AMI and group UAP was not statistically significant(P=0.346>0.05),AMI group was higher than SAP group,and UAP group was higher than SAP group,and the three groups were all higher than the control group,the difference was statistically significant(P<0.05).The difference of serum MMP-3 expression level between groups was statistically significant(P<0.01),AMI group was higher than UAP group,UAP group was higher than group SAP,and AMI group and UAP group were higher than control group,and there was no statistical difference between SAP group and control group(P=0.946>0.05).The difference of MMP-2 and MMP-9 expression levels between groups was statistically significant(P<0.01),AMI group was higher than UAP group,and the UAP group was higher than SAP group,and the three groups were all higher than control group,the difference was statistically significant(P<0.05).3.The expression level of EMMPRIN on platelets and monocytes in different plaque types.The EMMPRIN expression levels of platelets and mononuclear cells in different plaque types were significantly different(P<0.01),the soft plaque group was higher than the fibrous plaque group,and the fibrous plaque group was higher than the calcified plaque group,and the three groups were all higher than the control group,the difference was statistically significant(P<0.05).4 The expression level of serum MMP-1,MMP-2,MMP-3 and MMP-9 expression levels in different plaque types.The levels of MMP-1,MMP-2 and MMP-9 in different plaque types were statistically significant(P<0.01),the soft plaque group was higher than the fibrous plaque group,and the fibrous plaque group was higher than that of the calcified plaque group,and the three groups were all higher than the control group,the difference was statistically significant(P<0.05).The difference of MMP-3 expression level in different plaque types was statistically significant(P<0.01).There was no statistical difference between the calcified plaque group and the control group(P=0.493>0.05),the soft plaque group was higher than the fibrous plaque group,and the fibrous plaque group was higher than the calcified plaque group,and the two groups were higher than the control group,the difference was statistically significant.(P<0.05).5.The expression level of EMMPRIN on platelets and monocytes in different branches of pathological changes.The difference of EMMPRIN expression level on the surface of platelets and mononuclear cells of different branches of pathological changes was statistically significant(P<0.01).The three branches group was higher than the double branches group,and the double branches group was higher than the single branch group,and the three groups were all higher than the control group.The difference was statistically significant(P<0.05).6.The expression level of MMP-1,MMP-2,MMP-3 and MMP-9 in serum of different branches of pathological changes.The differences of the levels of MMP-1,MMP-2,MMP-3 and MMP-9 were statistically significant(P<0.01).There was no statistically significant difference between the three branches group and the double branches group(P>0.05).There was no statistical significance(P>0.05)between the two branches group and the single branch group(P>0.05),There was no statistical difference between the three branches group and the single branch group(P>0.05),but the three groups were higher than the control group.7.The serum MMP-1,MMP-2,MMP-3,MMP-9 and platelets and monocyte surface EMMPRIN correlation analysis.The serum levels of MMP-1,MMP-2,MMP-3 and MMP-9 were positively correlated with the EMMPRIN on the surface of the platelets,and the serum MMP-1,MMP-2,MMP-3,MMP-9 were positively correlated with the surface EMMPRIN of the mononuclear cells.Conclusions:1.EMMPRIN\MMP-15 MMP-2,MMP-3 and MMP-9 in the serum of ACS was significantly higher,indicating that MMP-1,MMP-2,MMP-3 and MMP-9 may play an important role in the de-velopment of ACS.2.EMMPRIN,MMP-1,MMP-2,MMP-3 and MMP-9 were related to plaquestability.3.The expression levels of MMP-1,MMP-2,MMP-3 and MMP-9 were independent of the number of lesions.4.MMP-1,MMP-2,MMP-3,MMP-9 were all positively related to the expression level of EMMPRIN,indicating that MMP-1,MMP-2,MMP-3,MMP-9 and EMMPRIN may be mutually regulating and acting in the process of ACS.5.The level of MMP-1,MMP-2,MMP-3,MMP-9,and the expression level of EMMPRIN on the surface of blood platelets and mononuclear cells,combined with 64 layers of spiral CT,is expected to provide early warning indicators for the clinical diagnosis of ACS. |
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