急性ST段抬高型心肌梗死患者血清sTWEAK、MMP-9水平变化及临床意义

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Abstract Objective To investigate the changes of soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) and matrix metalloproteinase-9 (MMP-9) in serum in patients with acute ST-segment elevation myocardial infarction (STEMI), and to evaluate their prognostic value. Methods From January to December 2018, 100 STEMI patients admitted to Cangzhou People’s Hospital, Hebei Province were selected as STEMI group, 100 stable angina patients as stable group, 100 unstable angina patients as unstable group and 100 patients without coronary atherosclerotic heart disease as the common group. The general data and the levels of sTWEAK and MMP-9 in each group were compared. STEMI patients were divided into a non-MACE group (61 cases) and MACE group (39 cases) according to whether major adverse cardiovascular events (MACE) occurred after 6 months of follow-up. sTWEAK and MMP-9 levels were compared between the non-MACE group and the MACE group. The related factors of MACE in STEMI patients were analyzed. The diagnostic value of sTWEAK and MMP-9 on prognosis of STEMI patients was analyzed by receiver operating characteristic. Results The STEMI group had higher serum sTWEAK and MMP-9 levels than the other groups (P ＜ 0.05). The serum levels of sTWEAK and MMP-9 in MACE group were higher than those in non-MACE group (P ＜ 0.05). Logistic analysis showed that sTWEAK (OR = 2.159, 95%CI [1.134, 4.109], P = 0.019) and MMP-9 (OR = 1.102, 95%CI [1.018, 1.193], P = 0.017) were independent predictors of MACE in STEMI patients. The area under the curve (AUC) of predicting MACE in STEMI patients by sTWEAK was 0.985, 95%CI (0.963, 1.000), the cutoff value was 78.57 pg/mL, the sensitivity and specificity were 89.70% and 100.00%, respectively. The AUC of predicting MACE in STEMI patients by MMP-9 was 0.773, 95%CI (0.684, 0.863), the cutoff value was 644.13 μg/L, the sensitivity and specificity were 100.00% and 16.00%, respectively. Conclusion The serum levels of sTWEAK and MMP-9 are high in patients with STEMI, and the high levels of sTWEAK and MMP-9 are independent risk factors for prognosis of MACE.

Key words： Acute ST segment elevation myocardial infarction Soluble tumor necrosis factor-like weak inducer of apoptosis Matrix metalloproteinase-9 Risk factors Prognosis

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	WANG Peng1 WANG Gang2 ZHANG Chunhe1 ZHANG Aimin1 MA Xiao1 ZUO Ruiju1

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WANG Peng1 WANG Gang2 ZHANG Chunhe1 ZHANG Aimin1 MA Xiao1 ZUO Ruiju1. Changes and clinical significance of serum sTWEAK and MMP-9 levels in patients with acute ST-segment elevation myocardial infarction[J]. 中国医药导报, 2020, 17(32): 20-23,39.

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