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目的探讨左向右分流先天性心脏病(CHD)患儿血清基质金属蛋白酶(MMPs)-2、9水平的变化及意义。方法采用ELISA方法检测并比较40例CHD患儿(其中无肺动脉高压组22例、肺动脉高压组18例)和20例健康患儿的血清MMP-2、MMP-9。结果 CHD无肺动脉高压组及肺动脉高压组患儿MMP-2(分别为206.14±20.62及258.83±31.44,pg/ml)、MMP-9(分别为207.68±20.77及240.00±31.10 pg/ml)与正常对照组相比均有显著性(P均小于0.05);而肺动脉高压组MMP-2及MMP-9水平明显高于无肺动脉高压组,差异有显著性(P均小于0.01)。CHD患儿血清MMP-2、MMP-9与LVEF、LVFS均无明显相关性(P>0.05);CHD患儿血清MMP-2及MMP-9浓度与肺动脉收缩压呈正相关(r分别为0.783及0.635,n=40,P<0.05)。结论 CHD肺动脉高压患儿血清MMP-2、MMP-9浓度升高并与肺动脉收缩压成正相关,提示MMP-2、MMP-9与肺动脉高压的病理生理有关。
Objective To investigate the changes and significance of serum matrix metalloproteinases (MMPs) -2,9 in children with left-sided shunt of congenital heart disease (CHD). Methods The serum levels of MMP-2 and MMP-9 in 40 children with CHD (including 22 without pulmonary hypertension and 18 with pulmonary hypertension) and 20 healthy children were detected by ELISA. Results MMP-2 (206.14 ± 20.62 and 258.83 ± 31.44, pg / ml) and MMP-9 (207.68 ± 20.77 and 240.00 ± 31.10 pg / ml, respectively) in children with CHD without pulmonary hypertension and pulmonary hypertension were significantly associated with normal (P <0.05), while the levels of MMP-2 and MMP-9 in pulmonary hypertension group were significantly higher than those in non-pulmonary hypertension group (P <0.01). The serum levels of MMP-2 and MMP-9 in children with CHD had no significant correlation with LVEF and LVFS (P> 0.05). The serum levels of MMP-2 and MMP-9 were positively correlated with pulmonary artery systolic pressure in CHD children (r = 0.635, n = 40, P <0.05). Conclusions Serum levels of MMP-2 and MMP-9 are positively correlated with pulmonary artery systolic pressure in children with CHD, suggesting that MMP-2 and MMP-9 are associated with the pathophysiology of pulmonary hypertension.