本文選題：基質(zhì)金屬蛋白酶-9 + 基質(zhì)金屬蛋白酶組織抑制因子-1　； 參考：《河北醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:基質(zhì)金屬蛋白酶-9(MMP-9)、基質(zhì)金屬蛋白酶組織抑制因子-1(TIMP-1)在細(xì)胞外基質(zhì)合成與降解平衡中起重要作用。其二者水平或比例的改變可引起心室重塑。本課題旨在通過(guò)觀察室間隔缺損患兒介入治療前后MMP-9、TIMP-1水平的變化,結(jié)合心臟超聲心動(dòng)圖心臟結(jié)構(gòu)及心功能狀態(tài)的測(cè)定,以了解其二者水平及比值的變化與患兒心室重塑的關(guān)系。方法:選取2016年1月-2016年9月在河北醫(yī)科大學(xué)第一醫(yī)院心內(nèi)科住院并經(jīng)超聲心動(dòng)圖檢查確診為左向右分流型室間隔缺損(VSD),且符合介入治療中國(guó)專家共識(shí)標(biāo)準(zhǔn)適宜行介入治療并已介入治療成功的患兒共33例作為治療組;男18例,女15例;年齡3歲~7歲(4.70±1.40歲)。對(duì)照組選取本院同期門診體檢健康兒童共20例,男11例,女9例;年齡3歲~7歲(4.82±1.31歲)。對(duì)所有研究對(duì)象均采集其臨床資料,對(duì)實(shí)驗(yàn)組的患兒介入治療前及術(shù)后24小時(shí)、術(shù)后5天、術(shù)后1個(gè)月、術(shù)后3個(gè)月、術(shù)后6個(gè)月及健康對(duì)照組兒童采血測(cè)定MMP-9、TIMP-1;同時(shí)在介入治療前、術(shù)后5天、術(shù)后1個(gè)月、術(shù)后3個(gè)月和術(shù)后6個(gè)月分別行超聲心動(dòng)圖檢查,其中主要評(píng)價(jià)心功能的指標(biāo)包括:右室橫徑(RVTD)、右房橫徑(RATD)、左房前后徑(LAAD)、左室收縮末前后徑(LVESD)、左室舒張末前后徑(LVEDD)、左室舒張末容積(LVEDV)、左室收縮末容積(LVESV)、每搏輸出量(SV)、左室射血分?jǐn)?shù)(LVEF)。介入治療前、術(shù)后24小時(shí)、術(shù)后5天、術(shù)后1個(gè)月、術(shù)后3個(gè)月和術(shù)后6個(gè)月觀察患兒心率、血壓、心臟雜音、是否存在心律失常等情況。統(tǒng)計(jì)學(xué)處理:采用SPSS21.0軟件進(jìn)行統(tǒng)計(jì)分析。結(jié)果:1治療組與對(duì)照組分別在性別、年齡、體重等參數(shù)上無(wú)顯著性差異;2 MMP-9、TIMP-1的變化:介入治療前兩者水平均較對(duì)照組升高;介入術(shù)后24小時(shí)出現(xiàn)短暫上升,術(shù)后5天開始逐漸下降,至術(shù)后6個(gè)月較術(shù)后3個(gè)月數(shù)值上雖有下降趨勢(shì),但無(wú)統(tǒng)計(jì)學(xué)意義,術(shù)后6個(gè)月與對(duì)照組無(wú)差異;3 MMP-9/TIMP-1比值的變化:介入治療前與治療后MMP-9/TIMP-1比值無(wú)明顯變化,與對(duì)照組相比無(wú)差異;4房室結(jié)構(gòu)及心功能的變化:介入術(shù)后5天、術(shù)后1個(gè)月、術(shù)后3個(gè)月及術(shù)后6個(gè)月RVTD、LAAD、LVEDD、LVESD、LVEDV、LVESV、SV均明顯小于術(shù)前,隨訪至術(shù)后6個(gè)月上述指標(biāo)逐步減小,而RATD、LVEF術(shù)后較術(shù)前變化不大。5 MMP-9、TIMP-1與心臟結(jié)構(gòu)及功能相關(guān)性:治療前后MMP-9、TIMP-1與RVTD、LAAD、LVEDD、LVESD、LVEDV、LVESV、SV均具有相關(guān)性,差異有統(tǒng)計(jì)學(xué)意義(P0.05),與RATD、LVEF無(wú)明顯相關(guān)性(P0.05)。MMP-9與TIMP-1的相關(guān)系數(shù)為0.870,差異有統(tǒng)計(jì)學(xué)意義(P0.01)。結(jié)論:血清MMP-9、TIMP-1水平可以有效反映室間隔缺損患兒的心室容量負(fù)荷、心腔結(jié)構(gòu)的改變,可作為早期評(píng)估室間隔缺損心室重塑的一個(gè)評(píng)價(jià)指標(biāo),其有助于評(píng)估室間隔缺損患兒封堵術(shù)后的遠(yuǎn)期療效及預(yù)后。
[Abstract]:Aim: Matrix metalloproteinase-9 (MMP-9), a tissue inhibitor of matrix metalloproteinase (TIMP-1), plays an important role in the balance of extracellular matrix synthesis and degradation. Changes in the level or ratio of both may lead to ventricular remodeling. The purpose of this study was to observe the changes of MMP-9 and TIMP-1 levels in children with ventricular septal defect (VSD) before and after interventional therapy, combined with the measurement of cardiac structure and cardiac function by echocardiography, in order to understand the relationship between the changes of the level and ratio of MMP-9 and TIMP-1 and ventricular remodeling in children with ventricular septal defect. Methods: selected from January 2016 to September 2016, hospitalized in the Department of Cardiology, first Hospital of Hebei Medical University, and diagnosed by echocardiography as left to right shunt ventricular septal defect (VSD). 33 cases were treated with interventional therapy and successful interventional therapy. There were 18 males and 15 females, aged from 3 to 7 years (4.70 鹵1.40 years). In the control group, 20 healthy children, 11 males and 9 females, aged from 3 years old to 7 years old, were selected from 20 healthy children in the same period of outpatient examination, who were 4.82 鹵1.31 years old. The clinical data were collected from all the subjects. 24 hours before and 24 hours after interventional therapy, 5 days after operation, 1 month after operation, 3 months after operation were performed on the children in the experimental group. The levels of MMP-9 and TIMP-1 were measured 6 months after operation and 6 months after operation in healthy children, and echocardiography was performed before, 5 days, 1 month, 3 months and 6 months after interventional therapy, respectively, before interventional therapy, 3 months after operation, 3 months after operation and 6 months after operation. The main indexes for evaluating cardiac function include right ventricular transverse diameter (RVTDV), right atrium transverse diameter (RATD), left atrial anterior and posterior diameter (LAADD), left ventricular end systolic diameter (LVESD), left ventricular end diastolic dimension (LVEDDN), left ventricular end-diastolic volume (LVEDVV), left ventricular end-systolic volume (LVESVV), and left ventricular output volume (LVEF). Left ventricular ejection fraction (LVEF). Heart rate, blood pressure, cardiac murmur and arrhythmia were observed before, 24 hours, 5 days, 1 month, 3 months and 6 months after interventional therapy. Statistical processing: SPSS21.0 software was used for statistical analysis. Results there was no significant difference in sex, age, body weight and other parameters between the two groups. The levels of MMP-9 and TIMP-1 before intervention were higher than those in the control group, and there was a brief increase at 24 hours after intervention. After 5 days, the value decreased gradually, but there was no significant difference between 6 months after operation and 3 months after operation. There was no significant change in the ratio of MMP-9/TIMP-1 before and after interventional therapy between the control group and the control group at 6 months postoperatively. There was no significant difference in the changes of atrioventricular structure and cardiac function between the two groups: 5 days after interventional therapy and 1 month after interventional therapy, there were no significant changes in the ratio of MMP-9/TIMP-1 before and after interventional therapy. At 3 months after operation and 6 months after operation, the SV of RVTDD-LVEDD-LVEDD-LVED-LVEDVLVESVV was significantly lower than that of pre-operation, and the above indexes gradually decreased after follow-up to 6 months after operation. However, the changes of RATDD-LVEF after operation were not significant compared with those before and after operation. The relationship between MMP-9TIMP-1 and LVELVELVELVESVSV was significant before and after treatment, and there was no significant correlation between MMP-9TIMP-1 and RVDD-LAVEADVELVELVELVEDVV LVESV before and after treatment. There was no significant correlation with RATDV LVEF. The correlation coefficient between MMP-9 and TIMP-1 was 0.870, and the difference was statistically significant (P 0.01). Conclusion: the level of MMP-9 and TIMP-1 in serum can effectively reflect the ventricular volume load and the changes of ventricular cavity structure in children with ventricular septal defect. It can be used as an early evaluation index for ventricular remodeling of ventricular septal defect. It is helpful to evaluate the long-term effect and prognosis of ventricular septal defect (VSD) in children with ventricular septal defect (VSD).
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R725.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 許發(fā)珍;鄔藝忠;周衍彬;江振強(qiáng);;先天性心臟病房室間隔缺損患者行外科修補(bǔ)術(shù)與封堵術(shù)治療的臨床療效比較[J];疑難病雜志;2016年10期

2 彭坤;趙文增;文冰;;食管超聲引導(dǎo)下經(jīng)皮房間隔缺損封堵術(shù)的臨床研究[J];鄭州大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2016年02期

3 佘亞鵬;徐更田;卞福寶;;室間隔缺損封堵術(shù)前后三維超聲心動(dòng)圖定量心功能對(duì)比[J];中國(guó)繼續(xù)醫(yī)學(xué)教育;2016年05期

4 汪希珂;王予川;吳悅;張陽(yáng);田穎;;轉(zhuǎn)錄因子GATA-4,-5,-6在中國(guó)人群先天性心臟病患兒中的突變篩查[J];中華實(shí)用兒科臨床雜志;2016年01期

5 甄潔;李曉霞;;TGF-β/TIMP-1/MMP-1信號(hào)通路在有氧運(yùn)動(dòng)改善心衰大鼠心臟重塑中的作用[J];中國(guó)康復(fù)醫(yī)學(xué)雜志;2015年12期

6 羅紅芳;譚慧蓮;張騰;呂鐵偉;;血漿心鈉素水平在反映房間隔缺損、室間隔缺損和動(dòng)脈導(dǎo)管未閉患兒介入封堵術(shù)后心臟結(jié)構(gòu)及心功能變化中的價(jià)值分析[J];中國(guó)現(xiàn)代醫(yī)學(xué)雜志;2015年21期

7 吳偉東;侯文進(jìn);劉丹;易永盛;王躍軍;林葦嘉;周洋洋;;MMP-3、MMP-9和TIMP-1的動(dòng)態(tài)平衡可作為心肌基質(zhì)重構(gòu)的重要標(biāo)志[J];分子影像學(xué)雜志;2015年02期

8 強(qiáng)海峰;張軍;;先天性心臟病患兒血清MMP-9、TIMP-1及VEGF表達(dá)水平及變化分析[J];海南醫(yī)學(xué)院學(xué)報(bào);2015年04期

9 張軍;王迪;;心力衰竭患兒血管緊張素轉(zhuǎn)化酶抑制劑治療對(duì)MMP-9、TIMP-1和BNP的影響[J];中國(guó)衛(wèi)生產(chǎn)業(yè);2014年28期

10 王肇俊;;老年慢性心力衰竭血清標(biāo)志物TNF-α和MMP-9的檢測(cè)及對(duì)預(yù)后判斷的價(jià)值[J];臨床心血管病雜志;2014年08期

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