MMP-9/TIMP-1比值与首发急性心肌梗死患者早期恶性室性心律失常的关系OA
The Relationship Between the MMP-9/TIMP-1 Ratio and Early Malignant Ventricular Arrhythmias in Patients with First-onset Acute Myocardial Infarction
目的 探讨基质金属蛋白酶9(MMP-9)/基质金属蛋白酶抑制剂1(TIMP-1)比值对首发急性心肌梗死(AMI)患者早期(≤48 h)恶性室性心律失常(MVA)的预测价值.方法 选择2024年5月至2025年4月南京医科大学姑苏学院附属昆山市第一人民医院收治的304例首发AMI患者为研究对象.根据患者AMI症状发生后48 h内MVA发生情况将患者分为MVA组(69例)和非MVA组(235例),比较两组患者经皮冠状动脉介入治疗术后24 h内血清MMP-9、TIMP-1水平和MMP-9/TIMP-1比值、临床资料;采用受试者工作特征(ROC)曲线分析MMP-9/TIMP-1比值对首发AMI患者早期MVA的预测价值;采用多因素Logistic逐步回归分析首发AMI患者早期MVA发生的影响因素.结果 MVA组患者血清MMP-9、TIMP-1水平及MMP-9/TIMP-1比值均高于非MVA组(P<0.05).ROC曲线分析显示,MMP-9/TIMP-1比值预测首发AMI患者早期MVA发生的曲线下面积为0.912(95%CI:0.862～0.957),明显高于血清MMP-9、TIMP-1单独预测[0.758(95%CI:0.708～0.815)、0.871(95%CI:0.821～0.916)](Z=12.912、10.629,均P<0.001).MVA组Killip分级Ⅲ～Ⅳ级比例、白细胞计数、中性粒细胞计数及肌酸激酶同工酶MB(CK-MB)、肌钙蛋白I水平高于非MVA组,血钾水平、左室射血分数(LVEF)低于非MVA组(P<0.05).多因素Logistic逐步回归分析显示,Killip分级Ⅲ～Ⅳ级(OR=2.392)、CK-MB升高(OR=2.050)、肌钙蛋白I升高(OR=2.522)、LVEF降低(OR=2.000)和MMP-9/TIMP-1比值升高(OR=2.962)均是首发AMI患者早期MVA发生的独立危险因素.结论 MMP-9/TIMP-1比值对首发AMI患者早期MVA发生具有一定的预测价值,MMP-9/TIMP-1比值升高是首发AMI患者早期MVA发生的独立危险因素之一.
Objective To explore the predictive value of the matrix metalloproteinase-9(MMP-9)/tissue inhibitor of metalloproteinase-1(TIMP-1)ratio for early(≤48 h)malignant ventricular arrhythmia(MVA)in patients with first-onset acute myocardial infarction(AMI).Methods A total of 304 patients with first-onset AMI admitted to the First People's Hospital of Kunshan Affiliated to Gusu College of Nanjing Medical University from May 2024 to April 2025 were selected.According to the occurrence of MVA within 48 hours after AMI symptom onset,patients were divided into the MVA group(69 cases)and the non-MVA group(235 cases).Serum MMP-9,TIMP-1 levels,the MMP-9/TIMP-1 ratio within 24 h after percutaneous coronary intervention,and clinical data were compared between the two groups.The predictive value of the MMP-9/TIMP-1 ratio for early MVA in patients with first-onset AMI was analyzed using receiver operating characteristic(ROC)curve analysis.Multivariate Logistic stepwise regression was used to analyze the influencing factors for early MVA in patients with first-onset AMI.Results Serum MMP-9,TIMP-1 levels,and the MMP-9/TIMP-1 ratio were higher in the MVA group than in the non-MVA group(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of the MMP-9/TIMP-1 ratio for predicting early MVA in patients with first-onset AMI was 0.912(95%CI:0.862-0.957),which was significantly higher than that of serum MMP-9 alone(AUC=0.758,95%CI:0.708-0.815)and TIMP-1 alone(AUC=0.871,95%CI:0.821-0.916)(Z=12.912 and 10.629,both P<0.001).The proportion of Killip class Ⅲ-Ⅳ,white blood cell count,neutrophil count,creatine kinase-MB(CK-MB),and troponin I levels were higher in the MVA group than in the non-MVA group,while serum potassium level and left ventricular ejection fraction(LVEF)were lower(P<0.05).Multivariate logistic stepwise regression analysis showed that Killip class Ⅲ-Ⅳ(OR=2.392),elevated CK-MB(OR=2.050),elevated troponin I(OR=2.522),decreased LVEF(OR=2.000),and an increased MMP-9/TIMP-1 ratio(OR=2.962)were independent risk factors for early MVA in patients with first-onset AMI.Conclusion The MMP-9/TIMP-1 ratio has certain predictive value for early MVA in patients with first-onset AMI,and an increased MMP-9/TIMP-1 ratio is one of the independent risk factors for early MVA in these patients.
曾繁龙;周家晖;陈言;高田云;吴霏儿;张梦瑶;刘杰;于宗良
南京医科大学姑苏学院附属昆山市第一人民医院心血管内科,江苏昆山 215300南京医科大学姑苏学院附属昆山市第一人民医院心血管内科,江苏昆山 215300江苏大学附属昆山市第一人民医院心血管内科,江苏昆山 215300江苏大学附属昆山市第一人民医院心血管内科,江苏昆山 215300江苏大学附属昆山市第一人民医院心血管内科,江苏昆山 215300江苏大学附属昆山市第一人民医院心血管内科,江苏昆山 215300江苏大学附属昆山市第一人民医院心血管内科,江苏昆山 215300南京医科大学姑苏学院附属昆山市第一人民医院心血管内科,江苏昆山 215300||江苏大学附属昆山市第一人民医院心血管内科,江苏昆山 215300
心肌梗死恶性室性心律失常基质金属蛋白酶9金属蛋白酶组织抑制剂1
myocardial infarctionmalignant ventricular arrhythmiamatrix metalloproteinase-9tissue inhibitor of metalloproteinase-1
《转化医学杂志》 2026 (4)
572-577,6
国家自然科学基金青年科学基金项目(81700737)苏州市科技计划项目(SKY2023028)
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