Abstract: Objective　To study the correlations between serum pentraxin 3 (PTX3) and matrix metalloproteinase 10 (MMP-10) levels and severity of acute coronary syndrome (ACS). Methods　The clinical data of 200 patients with ACS admitted to Emergency Department, Shenzhen Pingshan District People's Hospital from January 2019 to December 2021 were retrospectively analyzed. There were 65 cases of ST segment elevation myocardial infarction (STEMI), 70 cases of unstable angina pectoris (UAP), and 65 cases of non-ST segment elevation myocardial infarction (NSTEMI), and 60 normal healthy subjects were selected as the control group. There were 33 males and 32 females in the STEMI group, aged (56.92±4.66) years; there were 39 males and 26 females in the NSTEMI group, aged (56.73±5.04) years; there were 34 males and 36 females in the UAP group, aged (57.01±4.91) years; there were 30 males and 30 females in the control group, aged (57.64±3.89) years. Five ml of peripheral venous blood was drawn from the fasting for more than 8 hours, and the levels of triglyceride (TG), cardiac troponin I (cTnI), low-density lipoprotein cholesterol (LDL-C), and serum PTX3 and MMP-10 among all the subjects were detected and compared. The Gensini scores of the three ACS groups were compared and analyzed by Pearson correlation analysis, and the diagnostic efficacies of PTX3 and MMP-10 were compared. χ² test was used for the count data, and F test or independent sample t test was used for the measurement data. Results　The expression levels of cTnI, MMP-10, and PTX3 in the ACS patients were significantly higher than those in the normal healthy people (all P<0.05), and the expression levels of cTnI, MMP-10, and PTX3 in the STEMI group were significantly higher than those in the other three groups (all P<0.05). The Gensini score of the STEMI group was significantly higher than those of the NSTEMI group and the UAP group [(76.12±10.25) vs. (69.89±11.33) vs. (63.16±9.78)], and the Gensini score of the NSTEMI group was significantly higher than that of the UAP group (all P<0.05). Pearson correlation analysis showed that the expression levels of MMP-10 and PTX3 were positively correlated with Gensini score in the 200 ACS patients (r=0.232, P=0.022; r=0.144, P=0.031). The sensitivity and specificity of combined diagnosis of MMP-10+PTX3 were higher than those of MMP-10 or PTX3 alone, the positive predictive value was higher, and the area under the curve was larger (all P<0.05). Conclusion　The higher the expression of serum PTX3 and MMP-10, the more severe the symptoms of ACS patients, which is positively correlated, and the combination of PTX3 and MMP-10 is more effective as a diagnostic indicator.

Key words: Pentraxin 3, Matrix metalloproteinase 10, Acute coronary syndrome, Correlation, Diagnostic efficacy

摘要： 目的　研究血清五聚素3（PTX3）、基质金属蛋白酶10（MMP-10）与急性冠脉综合征（ACS）严重程度的相关性。方法　将2019年1月至2021年12月深圳市坪山区人民医院急诊科收治的200例ACS患者的临床资料进行回顾性分析，依据疾病类型分为ST段抬高型心肌梗死（STEMI）组65例，不稳定型心绞痛（UAP）组70例，非ST段抬高型心肌梗死（NSTEMI）组65例，另选入60例正常健康体检者作为对照组。STEMI组男33例，女32例，年龄（56.92±4.66）岁；NSTEMI组男39例，女26例，年龄（56.73±5.04）岁；UAP组男34例，女36例，年龄（57.01±4.91）岁；对照组男30例，女30例，年龄（57.64±3.89）岁。抽取其空腹8 h以上的外周静脉血5 ml，检测所有研究对象的三酰甘油（TG）、心肌肌钙蛋白I（cTnI）及低密度脂蛋白胆固醇（LDL-C）及血清PTX3、MMP-10并对比，比较3组ACS患者的Gensini评分，Pearson分析其相关性，对比PTX3、MMP-10的诊断效能。计数资料采用χ²检验，计量资料采用F检验或独立样本t检验。结果　ACS患者的cTnI、MMP-10及PTX3表达水平均明显高于正常健康人（均P<0.05），而STEMI组的cTnI、MMP-10及PTX3表达水平明显高于其余3组（均P<0.05）。STEMI组Gensini评分明显高于NSTEMI组及UAP组［（76.12±10.25）分比（69.89±11.33）分比（63.16±9.78）分］，且NSTEMI组Gensini评分明显高于UAP组（均P<0.05）。Pearson相关性分析显示，200例ACS患者MMP-10及PTX3的表达水平与Gensini评分呈正相关（r=0.232，P=0.022；r=0.144，P=0.031）。MMP-10+PTX3联合诊断的灵敏度及特异度均大于MMP-10、PTX3单独诊断，且阳性预测值更高，曲线下面积更大（均P<0.05）。结论　血清PTX3及MMP-10表达越高说明ACS患者症状越严重，呈正相关，且PTX3、MMP-10联合作为诊断指标效果更佳。

关键词: 五聚素3, 基质金属蛋白酶10, 急性冠脉综合征, 相关性, 诊断效能