有研究報告說明在急性心肌梗塞後併發心臟衰竭過程中膠蛋
白分解酵素-2 (MMP-2) 和 -9 的蛋白量表現及血中濃度。其收集
28 位急性心肌梗塞無心臟衰竭病人( Killip I)、27 位急性心肌
梗塞併心臟衰竭病人 (Killip II-III)(B 組) ，利用ELISA 及Zamograpgy等實驗方法，檢查血清中膠蛋白分解酵素-2 和MMP-9 的蛋白量表現及血中濃度，來探討心肌梗塞後併發心臟衰竭過程中，上列因子之濃度變化，藉以了解其可能扮演的角色。結果發現在急性心肌梗塞併心臟衰竭病人中MMP-9 有明顯增加(p<0.01) ，而MMP-2 在兩組卻無明顯增加。高MMP-9 血中濃度和發炎及心肌梗塞的範圍大小無關，而其真正機轉有待更進一步研究。其結論MMP-9 的蛋白量表現及血中濃度增加不僅為急性心肌梗塞後發生心臟衰竭的新指標，也提供此種疾病治療的可能病理機轉。
學生延續上述結果想觀察心臟衰竭病人血清中及胸水中MMP-2和MMP-9蛋白的表現，更進一步探討MMP-2和MMP-9蛋白與心臟衰竭病人性別的相關性。已有文獻報告證實了MMP-2與心臟衰竭發生的相關性，目前的研究已知在心臟衰竭病人的血清檢體中可發現MMP-2濃度；但是高MMP-9 血中濃度和發炎及心肌梗塞的範圍大小無關，而其真正機轉有待更進一步研究。本研究我們以Gelatin zymography的方法，來測定25個心臟衰竭病人MMP-2 和 MMP-9的濃度，其中包括25個胸水檢體和25個血清檢體。MMP-2及MMP-9在基底膜的破壞扮演著重要角色，且與癌症的侵襲及轉移最有關，實驗結果顯示心臟衰竭女性病人血清與其胸水比較可觀察有較高的MMP-9。

Myocardial infarction (MI) is the result, in mostly cases, of the destabilization and rupture of atherosclerotic lesions. The destruction of cardiac tissue resulting from myocardial ischemia could further result in heart failure. It has been suggested that plaque instability may be mediated by matrix metalloproteinase (MMP) family. Studies have identified increased MMP-2 and MMP-9 in human platelets, and acute myocardial infarction patients with elevated MMP-2 and MMP-9 levels. However, the alteration of MMP-2 and MMP-9 from post MI left ventricle remodeling to heart failure remains to be clarified. The purpose of this study is to investigate the serum concentrations and activities of MMP-2 and MMP-9 in the developing heart failure from post MI patients. Twenty eight patients with MI without heart failure (Killip FC I) (group A; compensated) and twenty seven MI patients with heart failure (Killip II-III) (group B; decompensated) were collected to evaluate the serum levels and activities of MMP-2 and MMP-9 by ELISA and Zymography, respectively. It was observed that the both serum levels and activities of MMP-9 significantly increased (P &lt; 0.01) in decompensated group compared to compensated group, but there was no significant difference of serum MMP-2 levels and activities between two groups. The highly elevated serum MMP-9 concentration of decompensated patients is not related with inflammatory or localized infarct area of myocardium and the real mechanisms remain to be revealed. We suggest that the increase of MMP-9 levels and activity may be used as a new marker to diagnose the development of heart failure in patients with post MI, and provide the therapeutic implications in the future.
Students extend the above-mentioned result wanting to observe the depleted patient of heart in the serum and behavior of MMP-2 and MMP-9 albumen in the pleural effusion, go still one step further to probe into MMP-2 , MMP-9 albumen and dependence of the depleted patient''s sex of heart. Have document report verify MMP-2 and heart depleted dependence that take place already, present research know depleted serum of patient examine body can find MMP-2 thickness in heart already; But the ranges of the thickness , inflammation and heart attack size has nothing to do in the high MMP-9 blood, and its real machine rotates and remains to go still one step further to study. This our method with Gelatin zymography of research, come to determine the depleted patient MMP-2 of 25 hearts and thickness of MMP-9, include 25 pleural effusion and examine body and 25 pieces of serum and examine the body. MMP-2 and destruction in the basis membrane of MMP-9 are playing an important role, and have something to do with the invasion and attack and transformation of the cancer most, the experimental result shows the depleted woman patient of heart serum and its pleural effusion can relatively observe higher MMP-9 .

壹、中英文摘要.........................................2
貳、縮寫檢索表．．．．．．．．．．．．．．．． ．．．．7
參、前言．．．．．．．．．．．．．．．．．．．．．．．8
肆、實驗動機．．．．．．．．．．．．．．．．．．．．．38
伍、實驗材料與方法．．．．．．．．．．．．．．．．．．39
陸、結果．．．．．．．．．．．．．．．．．．．．．．．46
柒、討論．．．．．．．．．．．．．．．．．．．．．．．52
捌、參考文獻．．．．．．．．．．．．．．．．．．．． 54

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