| Coronary artery disease is a progressive disease that results in a continuum of clinical manifestations, ranging from asymptomatic atherosclerosis and stable angina tothe acute coronary syndromes(ACS)--which include unstable angina,acutemyocardial infarction (AMI) and sudden ischemic death. All the ACS share common pathophysiology processes characterized by coronary plaque disruption with superimposed thrombus formation. Extracellular matrix (ECM) contains collagen characterized by flexibility and ductility. ECM can keep the integrality and prevent the disruption of the plaque. So the content, thickness and intensity of ECM are very important to prevent plaque to rupture. The most important factor contributed to the disruption of the plaque is the component and vulnerability of ECM. Investigations have revealed that the vulnerability of the plaque increases with augmentation of lipid core, attenuation of fibrous cap, reduction of collagen and smooth muscle cell(SMC) and increasing expression of matrix metalloproteinase(MMPs). MMPs can decompose ECM and make fibrous cap become thinner, thus cause damage and disruption of the plaque, and these factors accordingly influence the progression of ACS. So the effects of MMPs on the instability of plaque have caused much attention. The aim of our research is as follows: The increasing level of serum MMP-9 concentration of patients with ACS may reflect inflammation states of the arteries. And whether the concentration of serum MMP-9 can predict the severity of the disease or not.In our study, 67 patients were selected as acute coronary syndrome (ACS) group, 20 patients as stable angina (SA) and 20 persons as control. ACS group including 46 patients with unstable angina (UA) and 21 patients with acute myocardial infarction(AMI), UA cases in ACS group were separated into 2 parts by TIMI risk score: 24 patients with score 3 and 22 patients with score 2. The blood samples of the both control and angina group were drown from venous in the morning of the following day after hospitalization, and of the AMI group were drown from venous in the 24 hours after episode. The concentration of MMP-9 was detected by enzyme linked immune sorbent assay (ELISA), and the concentration of C-reactive protein (CRP) was detected by scatter turbidimetry method. The concentration of MMP-9 and CRP in each group was compared, so as the concentration of MMP-9 and CRP of unstable angina by TIMI risk score. Compare the concentrations of MMP-9 and CRP of patients with various grades lesion during the procedure of coronary angiography. All results of investigate were undertook correlation analysis.The results show: (1)UA, AMI and SA group were compared with control group, the serum concentration of MMP-9 is 103.456 7.985ng/ml, 182.667 22.816ng/ml, 63.375 4.094ng/ml, 49.05 3.819ng/ml, respectively, and the concentration of CRP is is 6.700+2.450 mg/L, 7.373 + 4.450 mg/L, 4.100 +1.125 mg/L, 4.069+0.485 mg/L, respectively, all of indexes are notably increasing(P<0.01). (2)Compared cases whose TIMI risk score 2 with those who score 3 shows a much higher concentration of MMP-9 in UA patients ( 127.15+10.37ng/ml vs. 76.38 +9.50ng/ml, P <0.01) , and the concentration of MMP-9 rises with the increase of TIMI risk score in a concentration dependant manner. The results show a positive correlation(r= 0.722, P <0.001). (3)According to the results of coronary angiography in patients with ACS, the patients with mild, moderate and serious lesion are 18, 21 and 28 cases respectively. The concentration of MMP-9 in moderate and serious lesion group was significant higher than that in mild lesion group(168.36 + 18.15ng/ml, 177.91+ 20.81ng/ml vs 82.94 +13.54ng/ml, P <0.001); paralleling the concentration of CRP is 7.31+2.05 mg/L, 7.74+2.16 mg/L vs 6.82+1.31mg/L (P <0.05) respectively. The results show a positive correlation between MMP-9 and vessel lesion (r=0.651, P<0.001). And the relation between CRP and the degree of vessel lesion is also positive correlation(r=0.441, P<0.01). (4) The relation...
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